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The Evaluation of Serum Tryptase Levels After Subcutaneous Immunotherapy-Associated Systemic Reactions
59th Medical Wing San Antonio United States
Pagination or Media Count:
Elevations in serum tryptase have been used to support the diagnosis of anaphylaxis but have not been measured systematically in patients who have systemic reactions SRs to immunotherapyIT. 16 patients with SRs to IT were enrolled in the study. Methods Adult patients receiving immunotherapy to aeroallergens andor venom and who experienced systemic reactions were recruited from December 2012 through November 2016. The severity of the reaction was graded according to the World Allergy Organization WAO Subcutaneous immunotherapySCIT Systemic Reaction Grading System. Total tryptase was obtained from stable patients an hour post-reaction. A second baseline tryptase level was drawn between 2-60 days after the reaction. Tryptase levels were measured using an immunofluorimetric assay lmmunoCAP, Phadia, Uppsala, Sweden.Discussion One patient had a reaction tryptase of 15.8 ugL, with a baseline tryptase of 4.4 ugL. Among the 15 other patients, the reaction tryptase ranged from 2.5-6.5 ugL. Of these patients, 9 out of16 returned for baseline tryptase levels, which ranged from 3.2-5. 7 ugL. Severity based on the WAOSCIT SR Grading System ranged from 1-2. Conclusion One patient out of 16 was observed to have an elevated total tryptase in our prospective cohort study of IT-associated systemic reactions. Tryptase appears to be of little clinical utility in evaluating mild SRs to IT however, larger studies are needed.
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