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Mast cell tryptase and hemolysis after trauma
Erik Edston1, Marianne van Hage-Hamsten
1Department of Forensic Medicine, University Hospital, S-581 85 Linköping, Sweden. eried@ihm.liu.se
Forensic Science International
|December 31, 2002
Summary
Mast cell tryptase levels significantly increase following trauma, indicating mast cell degranulation. This elevation is linked to direct injury and occurs acutely, impacting prognosis in severe trauma cases.
Area of Science:
- Forensic Pathology
- Immunology
- Trauma Medicine
Background:
- Previous studies indicated elevated mast cell tryptase in trauma deaths.
- Mast cell degranulation was inferred from prior findings.
Purpose of the Study:
- Confirm elevated mast cell tryptase in trauma.
- Investigate if tryptase release is acute or delayed.
- Examine the roles of hemolysis and direct trauma.
Main Methods:
- Mast cell tryptase measured in post-mortem femoral vein blood (27 trauma, 27 control).
- Trauma cases stratified by severity (single/multiple) and survival time (short/long).
- Local blood samples from crush injuries analyzed in five multi-trauma cases.
Main Results:
- Trauma group showed significantly higher tryptase (35.6 µg/l) than controls (14.7 µg/l).
- Crush injury sites had markedly elevated tryptase (227 µg/l).
- Tryptase was significantly higher in short-survival cases (P<0.001).
Conclusions:
- Trauma elevates mast cell tryptase, likely due to mechanical injury or cell lysis.
- Early mediator release in surviving trauma patients may influence treatment and prognosis.