Use and Interpretation of Acute and Baseline Tryptase in Perioperative Hypersensitivity and Anaphylaxis
| Autor: | Paul-Michel Mertes, Joana Vitte, Moïse Michel, Lene H. Garvey, Vito Sabato, Didier G. Ebo, Lawrence B. Schwartz, Mariana Castells, Charles Tacquard |
|---|---|
| Přispěvatelé: | Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), University of Antwerp (UA), Nouvel Hôpital Civil de Strasbourg, Herlev and Gentofte Hospital, Antwerp University Hospital [Edegem] (UZA), Virginia Commonwealth University (VCU), Harvard Medical School [Boston] (HMS), Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes) |
| Rok vydání: | 2021 |
| Předmět: |
Allergy
medicine.medical_specialty Consensus Myeloid Tryptase Mast cell 03 medical and health sciences Amniotic fluid embolism 0302 clinical medicine [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases Internal medicine Hypersensitivity medicine Humans Immunology and Allergy Anesthesia [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology Perioperative Mast Cells 030212 general & internal medicine [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology Anaphylaxis ComputingMilieux_MISCELLANEOUS [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases biology business.industry medicine.disease MESH: Anaphylaxis / diagnosis Mastocytosis Tryptases [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology 3. Good health Algorithm medicine.anatomical_structure 030228 respiratory system [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology biology.protein Human medicine Allergists business |
| Zdroj: | Journal of Allergy and Clinical Immunology: In Practice Journal of Allergy and Clinical Immunology: In Practice, Elsevier, 2021, 9 (8), pp.2994-3005. ⟨10.1016/j.jaip.2021.03.011⟩ The journal of allergy and clinical immunology. In practice Journal of Allergy and Clinical Immunology: In Practice, 2021, 9 (8), pp.2994-3005. ⟨10.1016/j.jaip.2021.03.011⟩ |
| ISSN: | 2213-2198 2213-2201 |
| Popis: | Paired acute and baseline serum or plasma tryptase sampling and determination have recently been included as a mechanistic approach in the diagnostic and management guidelines of perioperative immediate hypersensitivity and anaphylaxis. The timing of this paired sampling is clearly defined in international consensus statements, with the optimal window for acute tryptase sampling between 30 minutes and 2 hours after the initiation of symptoms, whereas baseline tryptase should be measured in a sample collected before the event (preop) or at least 24 hours after all signs and symptoms have resolved. A transient elevation of the acute tryptase level greater than [2 D (1.2 3 baseline tryptase level)] supports the involvement and activation of mast cells. Here, we provide the clinical, pathophysiological, and technical rationale for the procedure and interpretation of paired acute and baseline tryptase. Clinical examples, upto-date knowledge of hereditary alpha-tryptasemia as a frequent cause of baseline tryptase of 7 mg/L and higher, mastocytosis, other clonal myeloid disorders, cardiovascular or renal failure, and technical improvements resulting in continued lowering of the 95th percentile value are discussed. Clues for improved management of perioperative immediate hypersensitivity and anaphylaxis include (1) sustained dissemination and implementation of updated guidelines; (2) preoperative sample storage for deferred analysis; (3) referral for thorough allergy investigation, screening for mast cellerelated disorders, and recommendations for future anesthetic procedures; and (4) sustained collaboration between anesthesiologists, immunologists, and allergists. (C) 2021 American Academy of Allergy, Asthma & Immunology |
| Databáze: | OpenAIRE |
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