Elevated basal serum tryptase and hymenoptera venom allergy: relation to severity of sting reactions and to safety and efficacy of venom immunotherapy

Haeberli, Gabrielle; Brönnimann, M.; Hunziker, T.; Müller, Ulrich

doi:10.1046/j.1365-2222.2003.01755.x

Cited by 196 publications

(173 citation statements)

References 23 publications

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“…59 A positive correlation between baseline serum tryptase and grade of the initial allergic reaction has been reported. 63 Sensitization to 4. Palpable splenomegaly with hypersplenism.…”

Section: -58mentioning

confidence: 99%

How I treat patients with indolent and smoldering mastocytosis (rare conditions but difficult to manage)

Pardanani

2013

Blood

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Indolent systemic mastocytosis (SM) patients have a varied clinical presentation, ranging from predominantly cutaneous symptoms to recurrent systemic symptoms (eg, flushing, palpitations, dyspepsia, diarrhea, bone pain) that can be severe and potentially life threatening (anaphylaxis). Mastocytosis patients without skin involvement pose a diagnostic challenge; a high index of suspicion is needed in those with mast cell–degranulation symptoms, including anaphylaxis following Hymenoptera stings or other triggers. Modern-era molecular and flow-cytometric diagnostic methods are very sensitive and can detect minimal involvement of bone marrow with atypical/clonal mast cells; in some cases, full diagnostic criteria for SM are not fulfilled. An important aspect of treatment is avoidance of known symptom triggers; other treatment principles include a stepwise escalation of antimediator therapies and consideration of cytoreductive therapies for those with treatment-refractory symptoms. The perioperative management of mastocytosis patients is nontrivial; a multidisciplinary preoperative assessment, adequate premedications, and close intra- and postoperative monitoring are critical. Smoldering mastocytosis is a variant with high systemic mast cell burden. While its clinical course can be variable, there is greater potential need for cytoreductive therapies (eg, interferon-alpha, cladribine) in this setting. A systematic approach to the diagnosis and treatment of indolent SM using a case-based approach of representative clinical scenarios is presented here.

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“…59 A positive correlation between baseline serum tryptase and grade of the initial allergic reaction has been reported. 63 Sensitization to 4. Palpable splenomegaly with hypersplenism.…”

Section: -58mentioning

confidence: 99%

How I treat patients with indolent and smoldering mastocytosis (rare conditions but difficult to manage)

Pardanani

2013

Blood

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“…As positive and negative control solutions, respectively, histamine hydrochloride (5 g/L) and physiologic saline were used in all instances. Intradermal testing of patients with suspected insect venom allergies was performed by use of serial 10-fold dilutions of venom extracts (Venomil ® ; Bencard) with concentrations ranging from 0.0001 to 0.1 mg/L (18 ). The testing was performed with an insulin syringe and an injection volume of 0.05 mL.…”

Section: Skin Testingmentioning

confidence: 99%

Allergen-Specific IgE Measured by a Continuous Random-Access Immunoanalyzer: Interassay Comparison and Agreement with Skin Testing

et al. 2005

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“…Another feature of venom deaths is its relationship to mastocytosis. The UK register documented one case , and it is known that patients with mastocytosis have an elevation of tryptase at baseline that may lead to more severe reactions to venom (Ludolph-Hauser et al 2001, Haeberli et al 2003.…”

Section: Stinging Insect Venom Anaphylaxismentioning

confidence: 99%

Why Do People Die of Anaphylaxis?—A Clinical Review

Kumar

Teuber

Gershwin

2005

Journal of Immunology Research

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Anaphylaxis is a source of anxiety for patients and healthcare providers. It is a medical emergency that presents with a broad array of symptoms and signs, many of which can be deceptively similar to other diseases such as myocardial infarction, asthma, or panic attacks. In addition to these diagnostic challenges, anaphylaxis presents management difficulties due to rapid onset and progression, lack of appropriate self-treatment education and implementation by patients, severity of the allergic response, exacerbating medications or concurrent disease, and unpredictability. The most common causes of anaphylaxis are food allergies, stinging insects and immunotherapy (allergy shots) but idiopathic anaphylaxis, latex allergy and drug hypersensitive all contribute to the epidemiology. Reactions to IVP and other dyes are coined anaphylactoid reactions but have identical pathophysiology and treatment, once the mast cell has been degranulated. As many antigens can be the trigger for fatal anaphylaxis, it is useful to examine the features of each etiology individually, highlighting factors common to all fatal anaphylaxis and some specific to certain etiologies. Generally what distinguishes a fatal from non fatal reaction is often just the rapidity to apply correct therapy. Prevention is clearly the key and should identify high-risk patients in an attempt to minimize the likely of a severe reaction. Although fatal anaphylaxis is rare, it is likely underreported.

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Elevated basal serum tryptase and hymenoptera venom allergy: relation to severity of sting reactions and to safety and efficacy of venom immunotherapy

Cited by 196 publications

References 23 publications

How I treat patients with indolent and smoldering mastocytosis (rare conditions but difficult to manage)

How I treat patients with indolent and smoldering mastocytosis (rare conditions but difficult to manage)

Allergen-Specific IgE Measured by a Continuous Random-Access Immunoanalyzer: Interassay Comparison and Agreement with Skin Testing

Why Do People Die of Anaphylaxis?—A Clinical Review

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