POSTMORTEM DIAGNOSIS OF ACUTE ANAPHYLAXIS BY SERUM TRYPTASE ANALYSIS - A CASE-REPORT

被引:51
作者
ANSARI, MQ
ZAMORA, JL
LIPSCOMB, MF
机构
[1] SW INST FORENS SCI,DALLAS,TX
[2] PARKLAND MEM HOSP & AFFILIATED INST,DALLAS,TX 75235
关键词
ANAPHYLAXIS; TRYPTASE; POSTMORTEM; MAST CELL;
D O I
10.1093/ajcp/99.1.101
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Systemic anaphylaxis is an acute allergic emergency resulting from generalized mast cell degranulation. In the United States, it is estimated that anaphylaxis accounts for about 500 deaths each year. Hymenoptera-sting hypersensitivity is one of the most common causes of systemic anaphylaxis. The authors report a case of a healthy 26-year-old man who developed acute anaphylaxis after a bee sting, could not be resuscitated, and died within 1 hour. At autopsy, performed 14 hours after the event, the only pathologic findings were laryngeal edema and congestion of lung. Postmortem tryptase levels in the blood were obtained and were instrumental in confirming a diagnosis of acute anaphylaxis. This case is reported to discuss the difficulties associated with using traditional histamine levels in making a diagnosis of anaphylaxis and to validate the value of using tryptase levels to document acute anaphylaxis as a cause of death, even when serum is not obtained until many hours after death.
引用
收藏
页码:101 / 103
页数:3
相关论文
共 8 条
  • [1] ANAPHYLAXIS
    BOCHNER, BS
    LICHTENSTEIN, LM
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1991, 324 (25) : 1785 - 1790
  • [2] THE STRUCTURE AND AIRWAY BIOLOGY OF MAST-CELL PROTEINASES
    CAUGHEY, GH
    [J]. AMERICAN JOURNAL OF RESPIRATORY CELL AND MOLECULAR BIOLOGY, 1991, 4 (05) : 387 - 394
  • [3] A NEW RADIOIMMUNOASSAY FOR HUMAN MAST-CELL TRYPTASE USING MONOCLONAL-ANTIBODIES
    ENANDER, I
    MATSSON, P
    NYSTRAND, J
    ANDERSSON, AS
    EKLUND, E
    BRADFORD, TR
    SCHWARTZ, LB
    [J]. JOURNAL OF IMMUNOLOGICAL METHODS, 1991, 138 (01) : 39 - 46
  • [4] TRYPTASE LEVELS AS AN INDICATOR OF MAST-CELL ACTIVATION IN SYSTEMIC-ANAPHYLAXIS AND MASTOCYTOSIS
    SCHWARTZ, LB
    METCALFE, DD
    MILLER, JS
    EARL, H
    SULLIVAN, T
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1987, 316 (26) : 1622 - 1626
  • [5] TIME COURSE OF APPEARANCE AND DISAPPEARANCE OF HUMAN MAST-CELL TRYPTASE IN THE CIRCULATION AFTER ANAPHYLAXIS
    SCHWARTZ, LB
    YUNGINGER, JW
    MILLER, J
    BOKHARI, R
    DULL, D
    [J]. JOURNAL OF CLINICAL INVESTIGATION, 1989, 83 (05) : 1551 - 1555
  • [6] WASSERMAN SI, 1988, ALLERGY PRINCIPLES P, V2, P1365
  • [7] Wiggins CA, 1991, IMMUN ALLERGY PRACT, V13, P313
  • [8] YUNGINGER JW, 1991, J FORENSIC SCI, V36, P857