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Post mortem tryptase cut-off level for anaphylactic death.

R Tse1, C X Wong2, K Kesha1

  • 1Department of Forensic Pathology, LabPLUS, Auckland City Hospital, Auckland 1148, New Zealand.

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|January 15, 2018
PubMed
Summary
This summary is machine-generated.

Post mortem serum tryptase levels are elevated in anaphylaxis. A new cut-off of 53.8μg/L in femoral blood can aid in diagnosing anaphylactic deaths.

Keywords:
AnaphylaxisMast cell tryptasePost mortem

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Area of Science:

  • Forensic Pathology
  • Clinical Chemistry
  • Immunology

Background:

  • Serum mast cell tryptase aids in diagnosing anaphylaxis.
  • Current clinical cut-offs are unsuitable for post mortem samples due to elevated levels.
  • No established tryptase cut-off exists for diagnosing anaphylactic death.

Purpose of the Study:

  • To determine a reliable post mortem tryptase cut-off for diagnosing anaphylaxis.
  • To compare tryptase levels in post mortem blood from anaphylactic deaths and controls.
  • To assess factors influencing post mortem tryptase levels.

Main Methods:

  • Retrospective study of 9 anaphylactic deaths and 45 controls over 5 years.
  • Analysis of total tryptase levels in post mortem femoral blood.
  • Univariate, multivariate, and ROC curve analysis.

Main Results:

  • An optimal cut-off of 53.8μg/L for post mortem femoral blood tryptase was identified.
  • This cut-off demonstrated 89% sensitivity and 93% specificity for diagnosing anaphylaxis.
  • No other factors (age, gender, PMI, resuscitation) significantly affected post mortem tryptase levels.

Conclusions:

  • A post mortem femoral blood total tryptase level of 53.8μg/L or higher is a valuable ancillary marker for diagnosing anaphylaxis.
  • This finding provides a more reliable diagnostic tool in forensic investigations.
  • Further research may refine post mortem tryptase analysis in forensic contexts.