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Updated: Jul 18, 2026
07:49
Measuring Local Anaphylaxis in Mice
Published on: October 14, 2014
Pseudoanaphylaxis.
1Department of Anaesthesia, Royal Adelaide Hospital, University of Adelaide, Adelaide, South Australia, Australia.
Anaesthesia and Intensive Care
|December 23, 2006
Summary
Anaphylaxis suspicion after anesthesia was misdiagnosed. Persistent elevated mast cell tryptase indicated mastocytosis, revealing spinal anesthesia as the cause of hypotension and cardiac arrest.
Area of Science:
- Anesthesiology
- Allergy and Immunology
- Hematology
Background:
- Anesthesia-induced anaphylaxis is a rare but serious complication.
- Mast cell tryptase is a marker for anaphylaxis, but its elevation can be persistent in other conditions.
Observation:
- A patient experienced profound hypotension and cardiac arrest during combined spinal and general anesthesia for knee replacement.
- Initial mast cell tryptase levels were elevated, suggesting anaphylaxis.
- Subsequent skin testing failed to identify an allergic trigger.
Findings:
- A repeat mast cell tryptase test weeks later showed persistent elevation.
- This led to the diagnosis of mastocytosis.
- The patient's cardiovascular collapse was ultimately attributed to spinal anesthesia, not anaphylaxis.
Implications:
- Elevated serum tryptase during a suspected anaphylactic event necessitates further investigation.
- Persistent mast cell tryptase elevation may indicate underlying mastocytosis, requiring a differential diagnosis.
- This case highlights the importance of considering non-allergic causes for severe perioperative events.
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