Elevated Postmortem Tryptase in the Absence of Anaphylaxis

Elevations in tryptase, a recently discovered mast cell enzyme, have been proposed as a postmortem indicator of fatal anaphylaxis. The previous studies had limited numbers of controls and thus the specificity of the test with postmortem samples was not known. Therefore, tryptase was evaluated in pos...

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Bibliographic Details
Published in:Journal of forensic sciences 1995-03, Vol.40 (2), p.208-211
Main Authors: Randall, B, Butts, J, Halsey, JF
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Anaphylaxis - enzymology
Cause of Death
Child
Child, Preschool
Chymases
Female
Humans
Infant
Male
Mast Cells - enzymology
Middle Aged
Postmortem Changes
Serine Endopeptidases - blood
Thioridazine - poisoning
Tryptases
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Summary:Elevations in tryptase, a recently discovered mast cell enzyme, have been proposed as a postmortem indicator of fatal anaphylaxis. The previous studies had limited numbers of controls and thus the specificity of the test with postmortem samples was not known. Therefore, tryptase was evaluated in postmortem blood samples from 49 autopsy cases where there was no evidence of fatal anaphylaxis. The tryptase was above the normal serum threshold of 1 nanogram/mL (ng/mL) in 31 of these cases. Twenty-four cases had values in the 1 to 5 ng/mL range, two cases were between 5 and 10 ng/mL, and five were greater than 10 ng/mL. One autopsy specimen had a tryptase value of 106 ng/mL. The postmortem interval and the specimen storage condition did not appear to correlate with these elevations in tryptase. Although elevations in the postmortem tryptase remain an important supporting finding in the diagnosis of fatal anaphylaxis, it should not be used alone as the sole criterion for the postmortem diagnosis of anaphylaxis.
ISSN:0022-1198
1556-4029
DOI:10.1520/JFS15343J