The Utility of Serum Tryptase in the Diagnosis of Shrimp- Induced Anaphylaxis

The purpose of this study was to investigate the utility of serum tryptase for the confirmation of shrimp-induced anaphylaxis.

The diagnosis of anaphylaxis is based primarily on the clinical history. In some circumstances, inability to confirm the clinical diagnosis such as present with unusual manifestation, or when skin signs are absent likely contributes to underrecognition and undertreatment of the disease. Currently, products of mast cell activation (histamine and total tryptase) can be measure in clinical laboratories as markers of acute anaphylaxis events, however these tests have clinically relevant limitations. Therefore, development of laboratory tests with improved sensitivity and specificity that will support the clinical diagnosis of anaphylaxis are needed. In addition, shrimp is the major cause of seafood anaphylaxis among Thai children.

Patients with history of shrimp allergy and positive skin tests to shrimp were recruited for shrimp challenges After shrimp challenges, patients with anaphylaxis defined as anaphylaxis group, patients with mild reactions defined as mild reaction group, and patients without symptom defined as control group

Inclusion Criteria: a history of shrimp allergy Exclusion Criteria: severe anaphylactic reaction from seafood pregnancy underlying diseases such as cardiovascular, hepatobiliary, and renal diseases on systemic corticosteroid or β-blocking agents