Publication
Title
Mast cell activation during suspected perioperative hypersensitivity : a need for paired samples analysis
Author
Abstract
Background Perioperative hypersensitivity (POH) reactions constitute a significant clinical and diagnostic challenge. A transient increase in serum tryptase during POH reflects mast cell activation (MCA) and helps to recognize an underlying hypersensitivity mechanism. Objective To determine the diagnostic performance of different tryptase decision thresholds based on single and paired measurements to document MCA in suspected POH. Methods Acute serum tryptase (aST) and baseline serum tryptase (bST) samples were obtained from patients referred to our outpatients clinic because of clinical POH. Tryptase samples from controls were obtained before induction (Tt0) and 1.5 hours after induction (Tt1) in uneventful anesthesia. Different cutoff points for tryptase increase over bST and the percentage increase in tryptase (%T) were calculated and compared with existing thresholds: aST > [1.2 × (bST) + 2] (consensus formula), aST higher than 11.4 ng/mL, and aST higher than 14 ng/mL. Results Patients with POH had higher bST and aST levels compared with controls (respectively 5.15 vs 2.28 ng/mL for bST and 20.30 vs 1.92 ng/mL for aST). The consensus formula and a tryptase increase over bST of greater than or equal to 3.2 ng/mL held the highest accuracies to document MCA in POH (respectively 81% and 82%). A bST of higher than 8 ng/mL was present in 4% of controls, 5% of patients with grade 1 POH, 24% of patients with grade 2 POH, 15% of patients with grade 3 POH, and 17% of patients with grade 4 POH. Conclusions Our data endorse the consensus formula for detection of MCA in POH. Furthermore, it shows that a bST of higher than 8 ng/mL was associated with occurrence of anaphylaxis.
Language
English
Source (journal)
The journal of allergy and clinical immunology. In practice. - New York, NY, 2013, currens
Publication
New York, NY : Elsevier Inc , 2021
ISSN
2213-2198
DOI
10.1016/J.JAIP.2021.03.050
Volume/pages
9 :8 (2021) , p. 3051-3059.e1
ISI
000684981400016
Pubmed ID
33862269
Full text (Publisher's DOI)
Full text (open access)
UAntwerpen
Faculty/Department
Research group
Project info
Role of inhibitory receptors in piecemeal and anaphylactic degranulation of basophils and mast cells.
Can behaviour analysis of individual mast cells and basophils lift the veil of anaphylaxis in mastocytosis?
Infla-Med: Fundamental and translational research into targets for the treatment of inflammatory diseases.
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identifier
Creation 29.04.2021
Last edited 25.12.2024
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