Paired acute-baseline serum tryptase levels in perioperative anaphylaxis: An observational study

Allergy
Joana VitteMarc Leone

Abstract

Anaphylaxis is recognized mainly through clinical criteria, which may lack specificity or relevance in the perioperative setting. The transient increase in serum tryptase has been proposed since 1989 as a diagnostic tool. Sampling for well-defined acute and baseline determinations has been recommended. We assessed the performance of four proposed algorithms with tightly controlled time frames for tryptase sampling, their robustness with inadequate sampling times, and the possible use of mature tryptase determination. A retrospective study was performed on 102 adult patients from the Aix-Marseille University Hospitals who had experienced a perioperative hypersensitivity reaction clinically suggesting anaphylaxis. EAACI and ICON criteria were used to diagnose anaphylaxis. Mature and total serum tryptase levels were measured. Based on EAACI guidelines, clinical diagnostic criteria for anaphylaxis were found in 76 patients and lacking in 26. The most effective algorithm was the international consensus recommendation of 2012 that acute total tryptase levels should be greater than ([1.2×baseline tryptase] + 2] μg/L to be considered a clinically significant rise. In our cohort, this algorithm achieved 94% positive predictive value (PP...Continue Reading

References

Oct 1, 1978·Anesthesiology·W D OwensE L Spitznagel
May 1, 1994·Journal of Clinical Immunology·L B SchwartzP W Van der Linden
May 22, 2003·The Journal of Immunology : Official Journal of the American Association of Immunologists·Lawrence B SchwartzYoshihiro Fukuoka
Apr 5, 2011·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Arthur B VeghLawrence B Schwartz
Aug 26, 2011·Anesthesia and Analgesia·Carmelina GurrieriGerald W Volcheck
Nov 19, 2011·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·M Borer-ReinholdU Müller
Feb 1, 2011·The World Allergy Organization Journal·F Estelle R SimonsUNKNOWN World Allergy Organization
Jan 30, 2014·The Journal of Allergy and Clinical Immunology·Jonathan J LyonsTodd M Wilson
Apr 5, 2014·Allergy·P DemolyB Y- H Thong
Jun 10, 2014·Allergy·A MuraroUNKNOWN EAACI Food Allergy and Anaphylaxis Guidelines Group
Jun 13, 2014·The World Allergy Organization Journal·F Estelle R SimonsMargitta Worm
May 6, 2015·International Journal of Surgery·Nicholas J HackettJohn Y S Kim
Jun 24, 2015·Clinical and Molecular Allergy : CMA·Corrado MironeElide A Pastorello
Oct 28, 2015·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Phillip LiebermanStephen A Tilles
Nov 4, 2015·The World Allergy Organization Journal·F Estelle R SimonsAziz Sheikh
Oct 30, 2016·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·W EgnerK Green
Nov 23, 2016·Journal of Clinical Anesthesia·Robert E FreundlichSachin Kheterpal
Jun 22, 2017·The Journal of Allergy and Clinical Immunology. in Practice·Alicia Prieto-GarcíaMariana C Castells
Aug 7, 2017·The Journal of Allergy and Clinical Immunology·Mariana Castells
Feb 13, 2018·Immunological Reviews·Adrian M Piliponsky, Luigina Romani
Feb 20, 2018·The Journal of Allergy and Clinical Immunology. in Practice·Didier G EboVito Sabato
May 21, 2018·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·W EgnerN J N Harper
Jun 13, 2018·Frontiers in Immunology·Marcia Campillo-NavarroRommel Chacón-Salinas

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Citations

Sep 30, 2020·Allergy·Adriana ArizaTahia D Fernandez
Jul 12, 2021·Clinical Reviews in Allergy & Immunology·Deepti Vellaichamy Manian, Gerald W Volcheck
Aug 4, 2021·Allergy·Antonella MuraroUNKNOWN European Academy of Allergy and Clinical Immunology, Food Allergy, Anaphylaxis Guidelines Group
Sep 15, 2021·Allergy·Ismail OgulurCezmi A Akdis
Nov 7, 2021·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·Witchaya SrisuwatchariAnca-Mirela Chiriac

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