By Carole VanSickle Ellis
PHOENIX, Ariz -- November 16, 2010 -- Food-induced anaphylaxis is definitely linked to elevated serum tryptase levels, researchers reported here at the 2010 Annual Meeting of the American College of Allergy, Asthma and Immunology (ACAAI).
Testing for serum tryptase previously has been demonstrated to have clinical utility in confirming the diagnosis of anaphylaxis. But, food-induced anaphylaxis had been suggested to occur without concomitant elevations in serum tryptase, explained Ravi Gutta, MD, Respiratory Institute’s Cleveland Clinic, Cleveland, Ohio, speaking here on November 13. Dr. Gutta sought to confirm that food anaphylaxis was not associated with elevated post-event serum tryptase and to catalogue the antigens associated with anaphylaxis and with elevated serum tryptase.
Dr. Gutta and his fellow researchers were unable to confirm such a finding, however. They determined, instead, that both food and medications of different classes are associated with both anaphylaxis and elevated peri-event serum tryptase.
During their 8-year-long study, the research team examined the records of 23 subjects (20 adults, 3 children) who had experienced anaphylaxis and who had had a serum tryptase value drawn within 24 hours of onset.
The mean event tryptase was 53.1 mcg/L, and in 87% of subjects (the adult subjects) the antigen-triggering anaphylaxis was identified as drugs (15), insect venom (2), foods (1), latex (1), or radiocontrast media (1). Of the patients reviewed, 22 of the 23 survived the anaphylactic event.
Elevated serum tryptase can be identified in subjects experiencing anaphylaxis from a variety of triggers, including foods, the team concluded.
Dr. Gutta recommended additional studies with larger numbers of subjects to determine the relationship between food anaphylaxis and elevated serum tryptase.
Drugs identified as triggers in this study included ceftriaxone, cefazolin, cefuroxime, ketorolac, metronidazole, vancomycin, vitamin K, and succinylcholine.
[Presentation title: Identification of Triggers Associated With Anaphylaxis and Elevated Serum Tryptase. Abstract P6]
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