PMID- 1856650
OWN - NLM
STAT- MEDLINE
DCOM- 19910828
LR  - 20071114
IS  - 0022-1198 (Print)
IS  - 0022-1198 (Linking)
VI  - 36
IP  - 3
DP  - 1991 May
TI  - Laboratory investigation of deaths due to anaphylaxis.
PG  - 857-65
AB  - To establish a useful laboratory protocol to investigate possible cases of fatal 
      anaphylaxis, we measured mast-cell-derived tryptase levels and allergen-specific 
      immunoglobulin E (IgE) antibody levels in sera obtained prior to or within 24 h 
      after death from 19 anaphylaxis victims. Elevated serum tryptase levels (range = 
      12 ng/mL to 150 micrograms/mL) were found in nine of nine Hymenoptera sting 
      fatalities, six of eight food-induced fatalities, and two of two reactions to 
      diagnostic therapeutic agents. Tryptase levels were normal (less than 10 ng/mL) 
      in 57 sequential sera obtained postmortem from six control patients. Tryptase 
      could not be measured in pleural or pericardial fluids for technical reasons. 
      Serum IgE antibodies were elevated in five of the nine Hymenoptera sting 
      fatalities and in eight of the eight fatal food reactions; assays were 
      unavailable for the two diagnostic/therapeutic agents. If elevated, the victim's 
      serum IgE antibodies to food could be used to identify allergens in uneaten 
      portions of foods consumed shortly before the anaphylactic event. IgE antibodies 
      were moderately stable during storage in a variety of anticoagulants at room 
      temperature for up to 11 weeks. Elevated mast-cell-derived tryptase levels in 
      postmortem sera reflect antemortem mast cell activation and may be used as a 
      marker for fatal anaphylaxis. If assays are available for IgE antibodies to 
      relevant allergens, such assays provide evidence for antemortem sensitization; 
      these assays may be modified to identify allergens in foods consumed by victims 
      of food-induced anaphylaxis.
FAU - Yunginger, J W
AU  - Yunginger JW
AD  - Department of Pediatrics, Mayo Clinic, Rochester, MN.
FAU - Nelson, D R
AU  - Nelson DR
FAU - Squillace, D L
AU  - Squillace DL
FAU - Jones, R T
AU  - Jones RT
FAU - Holley, K E
AU  - Holley KE
FAU - Hyma, B A
AU  - Hyma BA
FAU - Biedrzycki, L
AU  - Biedrzycki L
FAU - Sweeney, K G
AU  - Sweeney KG
FAU - Sturner, W Q
AU  - Sturner WQ
FAU - Schwartz, L B
AU  - Schwartz LB
LA  - eng
GR  - AI-20487/AI/NIAID NIH HHS/United States
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - J Forensic Sci
JT  - Journal of forensic sciences
JID - 0375370
RN  - 0 (Allergens)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - EC 3.4.- (Peptide Hydrolases)
RN  - EC 3.4.- (tosylarginine methyl ester hydrolase)
SB  - IM
MH  - Aged
MH  - Allergens/analysis
MH  - Anaphylaxis/*diagnosis
MH  - Animals
MH  - *Cause of Death
MH  - Child
MH  - Female
MH  - Food Hypersensitivity/diagnosis
MH  - Humans
MH  - Hymenoptera
MH  - Immunoglobulin E/*analysis
MH  - Insect Bites and Stings
MH  - Male
MH  - Mast Cells/enzymology
MH  - Peptide Hydrolases/*blood
MH  - Radioallergosorbent Test
EDAT- 1991/05/01 00:00
MHDA- 1991/05/01 00:01
CRDT- 1991/05/01 00:00
PHST- 1991/05/01 00:00 [pubmed]
PHST- 1991/05/01 00:01 [medline]
PHST- 1991/05/01 00:00 [entrez]
PST - ppublish
SO  - J Forensic Sci. 1991 May;36(3):857-65.