Elevated serum tryptase levels in a patient with protracted anaphylaxis.

摘要: BACKGROUND: Anaphylactic reactions usually occur seconds to minutes after exposure the relevant antigen. Late onset, biphasic, and protracted anaphylaxis also occur. The incidence of prolonged responses is unknown, but may be common. In all nonfood-related cases, levels tryptase were not measured during episodes. Tryptase has been shown a useful specific indicator mast cell involvement in anaphylaxis. OBJECTIVE: To determine whether activation, as demonstrated by elevated serum concentrations, can METHODS: Case report; concentrations radioimmunoassay. RESULTS: A 33-year-old white man developed hives three days prior admission. next day, vomiting, abdominal cramps bloating, lower lip swelling, wheezing, feeling tightness over his throat chest experienced. gastrointestinal symptoms continued until hospital One day admission, he transient lightheadedness. On admission had generalized urticaria tenderness. Blood pressure 115/58 mm/Hg rose 180/60 heart rate fell from 107/min 90/min following 2.2 L intravenous fluids. Serum at 7.2 ng/mL 5.1 on first second (fourth fifth symptoms). was < 1.0 5 months later. CONCLUSIONS: 96 120 hours onset strongly suggest that degranulation This strengthens argument activation important pathophysiology