Şengül Emeksiz Zeynep, Yılmaz Deniz, Alan Başak, Tunc Secil Doga, Dibek Mısırlıoğlu Emine
From the University of Health Sciences, Ankara City Hospital, Department of Pediatric Allergy and Immunology, Ankara, Turkey; and.
University of Health Sciences, Ankara City Hospital, Department of Pediatrics, Ankara, Turkey.
Allergy Asthma Proc. 2022 Sep 1;43(5):e40-e46. doi: 10.2500/aap.2022.43.220042. Epub 2022 Jul 1.
This study aimed to evaluate the preliminary diagnosis, demographic characteristics, and outcomes of patients whose serum total tryptase levels were measured while in a tertiary pediatric hospital and to ascertain the role of serum tryptase levels in the etiology, diagnosis, severity, and course of systemic anaphylaxis. Patients ages between 1 month and 17 years who were followed up in the pediatric emergency department or as inpatients and with a diagnosis of immediate-type reactions between September 1, 2019, and August 31, 2021, were included in the study. Patient data were obtained retrospectively by examination of medical records and patient observation forms. It was determined that serum tryptase levels were measured in a total of 310 patients during the study period. One hundred and fifty-five patients who met the defined diagnostic criteria were named as the anaphylaxis group and their data were detailed. The serum tryptase elevation was detected in 15.5% of the patients among the samples that met the anaphylaxis diagnostic criteria. No relationship was found between the serum total tryptase levels, the triggering factor, and the severity of anaphylaxis. Anaphylaxis is a complex syndrome that involves different phenotypes that develop with various triggers in which different immunologic pathways, cell types, and mediators play a role. Serial measurements, including the basal value measured at least 24 hours after the symptoms disappear, are useful to confirm the diagnosis and guide the diagnostic tests during the follow-up, especially allergy evaluation.
本研究旨在评估在一家三级儿科医院测定血清总类胰蛋白酶水平的患者的初步诊断、人口统计学特征及预后，并确定血清类胰蛋白酶水平在全身性过敏反应的病因、诊断、严重程度及病程中的作用。纳入2019年9月1日至2021年8月31日期间在儿科急诊科或住院接受随访且诊断为速发型反应的1至17岁患者。通过查阅病历和患者观察表回顾性获取患者数据。研究期间共对310例患者测定了血清类胰蛋白酶水平。155例符合既定诊断标准的患者被纳入过敏反应组并详细记录其数据。在符合过敏反应诊断标准的样本中，15.5%的患者检测到血清类胰蛋白酶升高。未发现血清总类胰蛋白酶水平、触发因素与过敏反应严重程度之间存在关联。过敏反应是一种复杂的综合征，涉及不同表型，由各种触发因素引发，不同的免疫途径、细胞类型和介质在其中发挥作用。系列测量，包括症状消失后至少24小时测得的基础值，有助于确诊并在随访期间指导诊断检查，尤其是过敏评估。
