Cutaneous manifestations in Hymenoptera and Diptera anaphylaxis: relationship with basal serum tryptase - PubMed (original) (raw)
Cutaneous manifestations in Hymenoptera and Diptera anaphylaxis: relationship with basal serum tryptase
A Potier et al. Clin Exp Allergy. 2009 May.
Free article
Abstract
Objectives: To compare the clinical presentation of systemic anaphylaxis to Hymenoptera and Diptera with regard to basal serum tryptase (BT) and to evaluate mastocytosis in patients with elevated tryptase.
Patients and methods: The medical records of 140 patients with a history of a systemic reaction to venom were retrospectively reviewed. Symptoms and severity of anaphylaxis and BT were recorded. Most patients with elevated tryptase were screened for mastocytosis: a dermatological examination with a skin biopsy was performed in 19 cases and a bone marrow biopsy in 14 cases.
Results: Tryptase was elevated in 23 patients. These patients reported fewer usual skin reactions (urticaria in 26.1% of cases with raised tryptase vs. 76.1% of cases with normal tryptase), more flushing (52.2% vs. 4.3%) and frequently did not present skin reaction (26.1% vs. 9.4%). They presented a more severe reaction (mean grade of severity: 3.48 vs. 2.69). Mastocytosis was diagnosed in seven patients with elevated tryptase: indolent systemic mastocytosis in six cases and cutaneous mastocytosis without systemic involvement in one case. In five cases, mastocytosis was previously undiagnosed. Lesions of cutaneous mastocytosis, diagnosed in five patients, consisted of urticaria pigmentosa in all cases and were often inconspicuous.
Conclusion: These results demonstrate particular clinical features of the allergic reaction in patients with elevated BT and the higher frequency of mastocytosis in this population. In patients with a severe anaphylactic reaction without urticaria, but with flushing, tryptase should be assayed and an underlying mastocytosis should be considered.
Comment in
- Elevated baseline serum tryptase, mastocytosis and anaphylaxis.
Müller UR. Müller UR. Clin Exp Allergy. 2009 May;39(5):620-2. doi: 10.1111/j.1365-2222.2009.03251.x. Epub 2009 Apr 13. Clin Exp Allergy. 2009. PMID: 19400907 No abstract available.
Similar articles
- Basal serum tryptase as risk assessment for severe Hymenoptera sting reactions in elderly.
Guenova E, Volz T, Eichner M, Hoetzenecker W, Caroli U, Griesinger G, Burow G, Mitev V, Biedermann T. Guenova E, et al. Allergy. 2010 Jul;65(7):919-23. doi: 10.1111/j.1398-9995.2009.02302.x. Epub 2010 Feb 1. Allergy. 2010. PMID: 20121769 - Clonal mast cell disorders in patients with systemic reactions to Hymenoptera stings and increased serum tryptase levels.
Bonadonna P, Perbellini O, Passalacqua G, Caruso B, Colarossi S, Dal Fior D, Castellani L, Bonetto C, Frattini F, Dama A, Martinelli G, Chilosi M, Senna G, Pizzolo G, Zanotti R. Bonadonna P, et al. J Allergy Clin Immunol. 2009 Mar;123(3):680-6. doi: 10.1016/j.jaci.2008.11.018. Epub 2009 Jan 9. J Allergy Clin Immunol. 2009. PMID: 19135713 - Clonal mast cell disorders in patients with severe Hymenoptera venom allergy and normal serum tryptase levels.
Zanotti R, Lombardo C, Passalacqua G, Caimmi C, Bonifacio M, De Matteis G, Perbellini O, Rossini M, Schena D, Busa M, Marcotulli MC, Bilò MB, Franchini M, Marchi G, Simioni L, Bonadonna P. Zanotti R, et al. J Allergy Clin Immunol. 2015 Jul;136(1):135-9. doi: 10.1016/j.jaci.2014.11.035. Epub 2015 Jan 17. J Allergy Clin Immunol. 2015. PMID: 25605272 - Mastocytosis and insect venom allergy.
Bonadonna P, Zanotti R, Müller U. Bonadonna P, et al. Curr Opin Allergy Clin Immunol. 2010 Aug;10(4):347-53. doi: 10.1097/ACI.0b013e32833b280c. Curr Opin Allergy Clin Immunol. 2010. PMID: 20485157 Review. - Stinging Hymenoptera and mastocytosis.
Ruëff F, Dugas-Breit S, Przybilla B. Ruëff F, et al. Curr Opin Allergy Clin Immunol. 2009 Aug;9(4):338-42. doi: 10.1097/ACI.0b013e32832d2bc7. Curr Opin Allergy Clin Immunol. 2009. PMID: 19474708 Review.
Cited by
- Bone Marrow Mastocytosis: A Diagnostic Challenge.
Zanotti R, Tanasi I, Bernardelli A, Orsolini G, Bonadonna P. Zanotti R, et al. J Clin Med. 2021 Apr 1;10(7):1420. doi: 10.3390/jcm10071420. J Clin Med. 2021. PMID: 33915965 Free PMC article. Review. - Basophils from Cancer Patients Respond to Immune Stimuli and Predict Clinical Outcome.
Bax HJ, Chauhan J, Stavraka C, Khiabany A, Nakamura M, Pellizzari G, Ilieva KM, Lombardi S, Gould HJ, Corrigan CJ, Till SJ, Katugampola S, Jones PS, Barton C, Winship A, Ghosh S, Montes A, Josephs DH, Spicer JF, Karagiannis SN. Bax HJ, et al. Cells. 2020 Jul 7;9(7):1631. doi: 10.3390/cells9071631. Cells. 2020. PMID: 32645919 Free PMC article. - Risk factors for severe systemic sting reactions in wasp (Vespula spp.) and honeybee (Apis mellifera) venom allergic patients.
Fehr D, Micaletto S, Moehr T, Schmid-Grendelmeier P. Fehr D, et al. Clin Transl Allergy. 2019 Oct 11;9:54. doi: 10.1186/s13601-019-0292-5. eCollection 2019. Clin Transl Allergy. 2019. PMID: 31632639 Free PMC article. - Targeted Treatment Options in Mastocytosis.
Vaes M, Benghiat FS, Hermine O. Vaes M, et al. Front Med (Lausanne). 2017 Jul 20;4:110. doi: 10.3389/fmed.2017.00110. eCollection 2017. Front Med (Lausanne). 2017. PMID: 28775983 Free PMC article. Review. - Component Resolved Diagnosis in Hymenoptera Anaphylaxis.
Tomsitz D, Brockow K. Tomsitz D, et al. Curr Allergy Asthma Rep. 2017 Jun;17(6):38. doi: 10.1007/s11882-017-0707-0. Curr Allergy Asthma Rep. 2017. PMID: 28501976 Review.
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical