Baseline serum tryptase levels in a pediatric population

2021 ◽  
Vol 147 (2) ◽  
pp. AB136
Author(s):  
Alba Juarez ◽  
Alicia Dominguez ◽  
Joaquín Navarro ◽  
Maria Luisa Baeza ◽  
Alberto Alvarez-Perea
Keyword(s):  
Pediatric Population ◽  
Serum Tryptase ◽  
Baseline Serum

Insektengiftallergie: Anaphylaxie besser verstehen

2021 ◽  
Vol 9 (2) ◽  
pp. 80-81
Author(s):  
Dorothea Wieczorek
Keyword(s):  
Angiotensin Converting Enzyme Inhibitors ◽  
Severe Reaction ◽  
Serum Tryptase ◽  
Converting Enzyme Inhibitors ◽  
Specific Symptom ◽  
Baseline Serum ◽  
Tryptase Level ◽  
Symptom Profile ◽  
Organ Systems ◽  
Increased Risk

<b>Background:</b>Venom-induced anaphylaxis (VIA) is a common, potentially life-threatening hypersensitivity reaction associated with (1) a specific symptom profile, (2) specific cofactors, and (3) specific management. Identifying the differences in phenotypes of anaphylaxis is crucial for future management guidelines and development of a personalized medicine approach. <b>Objective:</b>This study aimed to evaluate the phenotype and risk factors of VIA. <b>Methods:</b>Using data from the European Anaphylaxis Registry (12,874 cases), we identified 3,612 patients with VIA and analyzed their cases in comparison with sex- and age-matched anaphylaxis cases triggered by other elicitors (non-VIA cases [n = 3, 605]). <b>Results:</b>VIA more frequently involved more than 3 organ systems and was associated with cardiovascular symptoms. The absence of skin symptoms during anaphylaxis was correlated with baseline serum tryptase level and was associated with an increased risk of a severe reaction. Intramuscular or intravenous epinephrine was administered significantly less often in VIA, in particular, in patients without a history of anaphylaxis. A baseline serum tryptase level within the upper normal range (8–11.5 ng/mL) was more frequently associated with severe anaphylaxis. <b>Conclusion:</b>Using a large cohort of VIA cases, we have validated that patients with intermediate baseline serum tryptase levels (8–11 ng/mL) and without skin involvement have a higher risk of severe VIA. Patients receiving β-blockers or angiotensin-converting enzyme inhibitors had a higher risk of developing severe cardiovascular symptoms (including cardiac arrest) in VIA and non-VIA cases. Patients experiencing VIA received epinephrine less frequently than did cases with non-VIA.

Idiopathic anaphylaxis: Diagnosis and management

2021 ◽  
Vol 42 (6) ◽  
pp. 481-488 ◽  
Author(s):  
Alyssa G. Burrows ◽  
Anne K. Ellis
Keyword(s):  
Food Allergy ◽  
Immunoglobulin E ◽  
Treatment Options ◽  
Serum Tryptase ◽  
Genetic Trait ◽  
Baseline Serum ◽  
Diagnostic Technologies ◽  
Term Management ◽  
Idiopathic Anaphylaxis

Introduction: Idiopathic anaphylaxis (IA) is a diagnosis of exclusion and is based on the inability to identify a causal relationship between a trigger and an anaphylactic event, despite a detailed patient history and careful diagnostic assessment. The prevalence of IA among the subset of people who experienced anaphylaxis is challenging to estimate and varies widely, from 10 to 60%; most commonly noted is ∼20% in the adult anaphylactic population. Comorbid atopic conditions, such as food allergy, allergic rhinitis, and asthma, are present in up to 48% of patients with IA. Improved diagnostic technologies and an increased understanding of conditions that manifest with symptoms associated with anaphylaxis have improved the ability to determine a more accurate diagnosis for patients who may have been initially diagnosed with IA. Methods: Literature search was conducted on PubMed, Google Scholar and Embase. Results: Galactose-α-1,3-galactose (α-gal) allergy, mast cell disorders, and hereditary a-tryptasemia are a few differential diagnoses that should be considered in patients with IA. Unlike food allergy, when anaphylaxis occurs within minutes to 2 hours after allergen consumption, α-gal allergy is a 3‐6-hour delayed immunoglobulin E‐mediated anaphylactic reaction to a carbohydrate epitope found in red meat (e.g., beef, lamb, pork). The more recently described hereditary α-tryptasemia is an inherited autosomal dominant genetic trait caused by increased germline copies of tryptase human gene alpha-beta 1 (TPSAB1), which encodes α tryptase and is associated with elevated baseline serum tryptase. Acute management of IA consists of carrying an epinephrine autoinjector to be administered immediately at the first signs of anaphylaxis. Long-term management for IA with antihistamines and other agents aims to potentially reduce the frequency and severity of the anaphylactic reactions, although the evidence is limited. Biologics are potentially steroid-sparing for patients with IA; however, more research on IA therapies is needed. Conclusion: The lack of diagnostic criteria, finite treatment options, and intricacies of making a differential diagnosis make IA challenging for patients and clinicians to manage.

scholarly journals Serum Creatinine Reference Limits in Pediatric Population—A Single Center Electronic Health Record-Based Database in Taiwan

2021 ◽  
Vol 9 ◽  
Author(s):  
Gwo-Tsann Chuang ◽  
I-Jung Tsai ◽  
Yong-Kwei Tsau
Keyword(s):  
Clinical Practice ◽  
Serum Creatinine ◽  
Creatinine Level ◽  
Pediatric Population ◽  
Function Evaluation ◽  
Medical Database ◽  
Specific Group ◽  
Baseline Serum ◽  
Reference Limits ◽  
Age And Sex

Objective: To assess age- and sex-specific serum creatinine levels in a pediatric population using a hospital-based database in Taiwan.Study Design: Data on serum creatinine levels were obtained from the National Taiwan University Hospital-integrated Medical Database (NTUH-iMD). Due to the possibility of having acute kidney injury or chronic kidney disease, individuals with multiple serum creatinine measurements were excluded, and outliers in each age- and sex-specific group were also subsequently removed. The remaining creatinine measurements in each group were analyzed, and 95% reference limits were established.Results: Serum creatinine data of individuals aged between 1 month and 18 years from May 2011 to January 2018 were retrieved. After applying the exclusion criteria, 27,911 individuals with a single corresponding serum creatinine measurement were enrolled. Creatinine level reference limits for each age- and sex-specific group were generated. The upper reference limits (URLs), which are particularly useful in clinical practice, followed the natural trend of increasing serum creatinine with age.Conclusion: We generated serum creatinine reference limits from a single hospital-integrated medical database in Taiwan for different age- and sex-specific groups of children. Our results will aid physicians in clinical practice regarding renal function evaluation, especially for patients without a recent baseline serum creatinine level.

scholarly journals Baseline Tryptase Levels Correlate with Baseline Basophil Levels in Chronic Myeloid Leukemia-Chronic Phase

2020 ◽  
pp. 171-176
Author(s):  
Anisha Mathew ◽  
Manisha Naithani ◽  
Sarama Saha ◽  
Rituparna Chetia ◽  
Uttam Kumar Nath
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Peripheral Blood ◽  
Myeloid Leukemia ◽  
Surrogate Marker ◽  
Chronic Phase ◽  
Newly Diagnosed ◽  
Serum Tryptase ◽  
Baseline Serum ◽  
Tryptase Level ◽  
Blood Basophil

Aims: To study whether there is any correlation between baseline blood basophil count and serum tryptase levels in newly diagnosed chronic phase chronic myeloid leukemia (CML-CP) patients. Settings and Design: 40 newly diagnosed CML-CP patients were enrolled from Medical Oncology Hematology OPD based on their baseline BCR-ABL status (done in department of Biochemistry). Methods and Materials: Serum tryptase level was measured using Sandwich ELISA and peripheral blood basophil count was estimated using automated cell counter & peripheral blood film examination. BCR-ABL quantification was done using real time PCR after conversion of RNA (extracted from whole blood) to cDNA. Statistical Analysis Used: SPSS Version 23. Results: Baseline peripheral blood basophil levels showed a significant correlation with baseline serum tryptase levels (p<0.01) and tryptase level also correlated with EUTOS score, which has basophil count as one of the parameters. This may signify that serum tryptase levels can be a surrogate marker of the basophil compartment in CML-CP. Conclusions: Based on findings of the present study and other studies available in literature, serum tryptase can be utilised as a surrogate marker of the basophil compartment in CML-CP.

Clinical characteristics and risk profile of patients with elevated baseline serum tryptase

2014 ◽  
Vol 42 (6) ◽  
pp. 544-552 ◽  
Author(s):  
C. Fellinger ◽  
W. Hemmer ◽  
S. Wöhrl ◽  
G. Sesztak-Greinecker ◽  
R. Jarisch ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Risk Profile ◽  
Serum Tryptase ◽  
Baseline Serum

scholarly journals Cutaneous mastocytosis in an infant: Case report and clinicopathological correlation

2021 ◽  
pp. 108-111
Author(s):  
Solanki Prithviraj Kishoresingh ◽  
Bhide Vijayshri ◽  
Gadage Vijaya ◽  
Kulkarni Vinay ◽  
Patki Anil
Keyword(s):  
Pediatric Population ◽  
Blue Staining ◽  
Serum Tryptase ◽  
Toluidine Blue Staining ◽  
Clonal Proliferation ◽  
Normal Limits ◽  
Organ Systems ◽  
Uncommon Condition ◽  
Metachromatic Granules ◽  
Cutaneous Mastocytosis

Mastocytosis is a disorder of clonal proliferation of the mast cells, which can be cutaneous or systemic. Abnormal mast cell infiltration comprising multifocal compact clusters or cohesive aggregates can affect one or more organ systems. Cutaneous mastocytosis is a relatively uncommon condition in the pediatric population. We report a case of 9 month infant presented with multiple papular and vesicular skin rashes since 6 months of age. On clinical examination Darier’s sign was negative. The serum tryptase levels were within normal limits. Clinical differential diagnoses were benign cephalic histiocytosis vs cutaneous mastocytosis. Skin biopsy revealed a mononuclear cell infiltrate in the papillary dermis reaching up to the dermo-epidermal junction. Toluidine blue staining highlighted the metachromatic granules. CD117, CD30 IHC stains were positive which confirmed the diagnosis of cutaneous mastocytosis. This case is presented to highlight the histomorphology and the special stains in cases of mastocytosis.

scholarly journals Risk factors for severe systemic sting reactions in wasp (Vespula spp.) and honeybee (Apis mellifera) venom allergic patients

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Danielle Fehr ◽  
Sara Micaletto ◽  
Thomas Moehr ◽  
Peter Schmid-Grendelmeier
Keyword(s):  
Risk Factors ◽  
Specific Ige ◽  
Latency Time ◽  
Serum Tryptase ◽  
Wasp Venom ◽  
Baseline Serum ◽  
Skin Symptoms ◽  
Sting Reaction ◽  
Potential Risk Factors ◽  
Specific Ige Antibodies

Abstract Background Hymenoptera stings are a major cause of anaphylaxis. Various risk factors are discussed in literature. This study aims to investigate potential risk factors for severe sting reactions in wasp (Vespula spp.) and honeybee (Apis mellifera) venom allergic patients and analyses the correlation between diagnostic test results and the severity of the allergic reaction. Methods 480 patients suffering from wasp or honeybee venom allergy were included in this retrospective case series. Only individuals allergic to Vespula spp. but not to other vespids such as Polistes were considered. The severity of their systemic field sting reaction was analysed with regard to the amount of specific IgE antibodies to whole venom extracts and to major allergens of honeybee and/or wasp venom. Furthermore, the following potential risk factors for severe sting reactions were examined: age, sex, latency time, skin symptoms, baseline serum tryptase levels and the concentration of venom inducing a positive intracutaneous test. Results The two following indicators for severe systemic sting reactions in honeybee and wasp venom allergic patients have been identified: a short latency time and the absence of skin symptoms. The patient’s age and baseline serum tryptase levels have been found to positively correlate with the grade of the sting reaction only in individuals allergic to wasp venom. No correlation could be found between the degree of sensitisation and the severity of the allergic reaction. Neither the amount of specific IgE antibodies to whole venom extracts nor to major allergens were significantly associated with the severity of the sting reaction. Conclusion The clinical history is essential for the allergological workup and therapeutic decision on Hymenoptera venom allergies. A short latency time and the absence of skin symptoms are indicators for severe systemic sting reactions, followed by the patient’s age and baseline serum tryptase levels.

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