β-Tryptase measurements post-mortem in anaphylactic deaths and in controls

Deaths from bee stings: a report of three cases from Pretoria, South Africa

“…[5,7,17] Blood should be taken for tryptase levels and immunological screening (IgE) as these results may aid in the diagnosis. [5,6,18] The stability of post mortem tryptase levels has been questioned with reports indicating an elevation with a prolonged post mortem interval and other authors not reporting a correlation. [18,19] It is advised that these tests be conducted within 48 hours following death.…”

“…[5,6,18] The stability of post mortem tryptase levels has been questioned with reports indicating an elevation with a prolonged post mortem interval and other authors not reporting a correlation. [18,19] It is advised that these tests be conducted within 48 hours following death. [20] The exact level of tryptase which should support the diagnosis of anaphylaxis also differs in the literature and is said to be influenced by post mortem interval, site of collection and cause of death.…”

“…[20] The exact level of tryptase which should support the diagnosis of anaphylaxis also differs in the literature and is said to be influenced by post mortem interval, site of collection and cause of death. [7,18,21,22]. Edston et al reported in 2007 that typtase levels should be taken from femoral blood and that the normal upper level in 95% of cases was recorded as 44.3μg/l.…”

Postmortem chemistry update part II

“…Histamine degrades too rapidly after death to be a reliable postmortem marker. Tryptase is more stable, has a longer half-life and can be detected from a few minutes up to several hours after mast cell degranulation [99,100]. Analyses of tryptase in postmortem serum samples of suspected anaphylaxis and anaphylactoid reactions have consistently shown elevated values [99][100][101][102][103][104][105][106][107][108][109][110][111][112].…”

“…Tryptase is more stable, has a longer half-life and can be detected from a few minutes up to several hours after mast cell degranulation [99,100]. Analyses of tryptase in postmortem serum samples of suspected anaphylaxis and anaphylactoid reactions have consistently shown elevated values [99][100][101][102][103][104][105][106][107][108][109][110][111][112]. However, increased tryptase levels have also been demonstrated in other situations, including sudden death infant syndrome, acute death after heroin injection, atherosclerotic cardiovascular disease, and traumatic death [100,111,[113][114][115][116][117][118][119][120][121][122].…”