Tryptase

General information

Blood tryptase levels are increased in most cases of severe systemic anaphylaxis and cardiovascular manifestations (hypotension). Beta-tryptase is secreted together with histamine from mast cell granules, but penetrates the tissues more slowly due to the fact that it is bound in a complex with proteoglycans. Peak concentrations are found from 15-30 to 120 minutes from the onset of the anaphylactic reaction compared to histamine, whose levels peak at 5 minutes and fall to a basal level at 15-30 minutes.
This time window has led to the practical application of testing serum tryptase levels in cases of anaphylaxis as a valuable method for the differential diagnosis of shock states to differentiate from cardiogenic, septic, hypovolemic shock, and severe vasovagal reaction. High levels of serum tryptase have been found up to three days postmortem in cases of suspected anaphylaxis.
Measuring the level of serum tryptase is an important study that should have a place in the fight to save the patient in a state of shock. It can aid diagnosis and appropriate management in cases of unclear precipitating factors and conditions.
In cases of recurrent anaphylaxis and that after wasp and bee stings, the examination of serum tryptase, as well as subsequent measurement of the baseline level, at least after 24 hours, can also detect the rare disease mastocytosis. It is not always possible to say with certainty that a value above the upper limit of normal is a sure marker for anaphylaxis, and normal values do not rule out the diagnosis. But in the context of the clinical picture, with the help of the result of testing the level of tryptase in the blood, we will come much closer to the correct diagnosis, the correct behavior in each individual case and, most importantly, the prevention of potentially fatal future incidents.

Sample required:

Venous blood

Key words:

tryptase, allergy