POSTMORTEM DIAGNOSIS OF ACUTE ANAPHYLAXIS BY SERUM TRYPTASE ANALYSIS - A CASE-REPORT
POSTMORTEM DIAGNOSIS OF ACUTE ANAPHYLAXIS BY SERUM TRYPTASE ANALYSIS - A CASE-REPORT
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DOI：
10.1093/ajcp/99.1.101
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发表时间：
1993-01-01
影响因子：
3.5
通讯作者：
LIPSCOMB, MF
中科院分区：
文献类型：
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作者：
ANSARI, MQ;ZAMORA, JL;LIPSCOMB, MF
全身性过敏反应是由全身肥大细胞脱颗粒引起的急性过敏急症。在美国，据估计每年约有 500 人因过敏反应死亡。膜翅目螫刺过敏是全身过敏反应的最常见原因之一。作者报道了一名 26 岁健康男性的病例，他在被蜜蜂蜇伤后出现急性过敏反应，无法复苏，并在 1 小时内死亡。事件发生 14 小时后进行尸检，唯一的病理结果是喉部水肿和肺充血。获得死后血液中的类胰蛋白酶水平，有助于确认急性过敏反应的诊断。据报道，该病例讨论了使用传统组胺水平诊断过敏反应的困难，并验证使用类胰蛋白酶水平记录急性过敏反应作为死亡原因的价值，即使在死亡后数小时才获得血清。
Systemic anaphylaxis is an acute allergic emergency resulting from generalized mast cell degranulation. In the United States, it is estimated that anaphylaxis accounts for about 500 deaths each year. Hymenoptera-sting hypersensitivity is one of the most common causes of systemic anaphylaxis. The authors report a case of a healthy 26-year-old man who developed acute anaphylaxis after a bee sting, could not be resuscitated, and died within 1 hour. At autopsy, performed 14 hours after the event, the only pathologic findings were laryngeal edema and congestion of lung. Postmortem tryptase levels in the blood were obtained and were instrumental in confirming a diagnosis of acute anaphylaxis. This case is reported to discuss the difficulties associated with using traditional histamine levels in making a diagnosis of anaphylaxis and to validate the value of using tryptase levels to document acute anaphylaxis as a cause of death, even when serum is not obtained until many hours after death.