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Title
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Diagnostic significance of tryptase for suspected mast cell disorders
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Author
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Abstract
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| Tryptase has proven to be a very useful and specific marker to demonstrate mast cell activation and degranulation when an acute (i.e., within 4 h after the event) and baseline value (i.e., at least 24 h after the event) are compared and meet the consensus formula (i.e., an increase of 20% + 2). The upper limit of normal determined by the manufacturer is 11.4 ng/mL; however, this boundary has been the subject of debate. According to ECNM and AIM experts, the normal range of baseline tryptase should be 1 to 15 ng/mL. A genetic trait, hereditary alpha tryptasemia, characterized by an increased alpha coding TPSAB1 copy number is associated with a baseline value above 8 ng/mL. Elevated tryptase can also be found in chronic kidney disease, obesity, and hematological neoplasms. A tryptase > 20 ng/mL serves as a minor criterion to diagnose systemic mastocytosis and an increase in tryptase > 20% + 2 during an acute event is a required criterion in the diagnosis of mast cell activation syndrome. The goal of this review is to demonstrate the (in)significance of tryptase using some clinical vignettes and to provide a practical guide on how to manage and interpret an elevated tryptase level. |
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Language
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English
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Source (journal)
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Diagnostics
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Publication
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2023
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ISSN
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2075-4418
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DOI
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10.3390/DIAGNOSTICS13243662
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Volume/pages
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13
:24
(2023)
, p. 1-12
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Article Reference
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3662
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ISI
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001132619500001
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Pubmed ID
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38132246
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Medium
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E-only publicatie
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Full text (Publisher's DOI)
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Full text (open access)
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