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Titolo:
Histamine and tryptase levels in patients with acute allergic reactions: An emergency department-based study
Autore:
Lin, RY; Schwartz, LB; Curry, A; Pesola, GR; Knight, RJ; Lee, HS; Bakalchuk, L; Tenenbaum, C; Westfal, RE;
Indirizzi:
St Vincents Hosp & Med Ctr, New York Med Coll, Dept Med, New York, NY 10011 USA St Vincents Hosp & Med Ctr New York NY USA 10011 , New York, NY 10011 USA St Vincents Hosp & Med Ctr, New York Med Coll, Dept Emergency Med, New York, NY 10011 USA St Vincents Hosp & Med Ctr New York NY USA 10011 , New York, NY 10011 USA Virginia Commonwealth Univ, Dept Med, Richmond, VA 23284 USA Virginia Commonwealth Univ Richmond VA USA 23284 , Richmond, VA 23284 USA
Titolo Testata:
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
fascicolo: 1, volume: 106, anno: 2000,
parte:, 1
pagine: 65 - 71
SICI:
0091-6749(200007)106:1<65:HATLIP>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
MAST-CELL TRYPTASE; ANAPHYLACTOID REACTIONS; PLASMA HISTAMINE; TIME-COURSE; CHILDREN; MARKERS; BLOOD; FOOD;
Keywords:
histamine; tryptase; emergency department; beta-tryptase; hypersensitivity;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
23
Recensione:
Indirizzi per estratti:
Indirizzo: Lin, RY St Vincents Hosp & Med Ctr, New York Med Coll, Dept Med, 153 W 11th St, New York, NY 10011 USA St Vincents Hosp & Med Ctr 153 W 11th St New York NY USA 10011 USA
Citazione:
R.Y. Lin et al., "Histamine and tryptase levels in patients with acute allergic reactions: An emergency department-based study", J ALLERG CL, 106(1), 2000, pp. 65-71

Abstract

Background: Emergency department visits for acute allergic reactions are common. Although the diagnosis and classification of these allergic reactions is primarily empiric, it is not always clear whether certain signs and symptoms constitute systemic mediator release syndromes, such as anaphylaxis,and thus may warrant more aggressive therapy or follow-up. Objective: We sought to determine associations between various clinical signs and symptoms with both plasma histamine levels and serum tryptase levels in adult patients presenting to an emergency department with acute allergic syndromes. The clinical correlates of raised beta-tryptase levels were also investigated. Methods: Ninety-seven adult emergency department patientswere prospectively studied by using a questionnaire, physical examination,and serum-plasma sampling. Plasma histamine and serum total and beta-tryptase levels were determined. Clinical groupings were compared for mediator levels by using simple and multivariate analysis. Results: Elevated levels of plasma histamine (>10 nmol/L) and serum total tryptase (>15 ng/mL) were observed in 42 and 20 patients, respectively. Detectable P-tryptase (greater than or equal to 1 ng/mL) was observed in 23 patients, including 15 of the patients with elevated total tryptase levels. Suspected food allergy incidences and the duration of reaction were similar in patients with increased histamine levels and in patients with increased tryptase levels. Increased total tryptase levels, histamine Levels, or bothwere observed in some patients who did not have airway, cardiovascular, orabdominal signs. Histamine levels correlated better with clinical signs than tryptase levels. Histamine elevations (>10 nmol/L) were observed more frequently in patients characterized by the following clinical signs in univariate analysis: the presence of urticaria, more extensive erythema, abnormal abdominal findings, and wheezing. Total tryptase increases were observed more Frequently only in patients with urticaria. Histamine levels correlated with initial heart rates. In multivariate analysis the extent of urticaria was the best single predictor of plasma histamine levels and of either anelevated histamine or tryptase Level. Detectable beta-tryptase levels wereobserved in some patients who had neither elevated total tryptase nor elevated histamine levels. Unlike patients without detectable beta-tryptase levels, patients who had detectable beta-tryptase levels had a significant correlation between total tryptase and histamine levels (P < .05). Conclusions: Raised histamine and, less commonly, raised tryptase levels are observed in almost 50% of patients presenting to emergency departments with acute allergic reactions. Some cases associated with systemic mediator release do not have classical features of severe anaphylaxis, such as hypotension or tachycardia. The lack of total tryptase elevations in many patients with elevated plasma histamine levels suggests basophil involvement. Theclinical utility of beta-tryptase determinations in the evaluation of acute allergic reactions needs further study.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/01/21 alle ore 11:23:03