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Mast cell tryptase in postmortem serum - Reference values and confounders
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Computer and Information Science, Statistics. Linköping University, Faculty of Arts and Sciences.
2007 (English)In: International journal of legal medicine (Print), ISSN 0937-9827, E-ISSN 1427-1596, Vol. 121, no 4, 275-280 p.Article in journal (Refereed) Published
Abstract [en]

We have investigated the effects of some factors suspected of inducing spuriously increased tryptase concentrations, specifically sampling site, conjunctival petechial bleeding and prone position at the time of death as indicators of premortem asphyxia, and resuscitation efforts by external cardiac massage. Tryptase was measured in blood from the femoral vein in 60 deaths: 39 control cases who died rapidly (within minutes) from natural causes (sudden cardiac death and acute aortic dissection), 16 with death caused by prolonged asphyxia (traumatic compression of the chest and suffocation due to body position or smothering), and five anaphylactic deaths. In 44 of these cases, tryptase was measured in both heart and femoral blood. Mast cell tryptase was analyzed with a commercial FEIA method (Pharmacia Diagnostics AB, Uppsala, Sweden) measuring both a- and ß-tryptase. Assuming that tryptase values in the control group were gamma distributed, we calculated the upper normal limits for tryptase concentrations in femoral blood. It was found that 95% of the controls had values below 44.3 µg/l (femoral blood), SD 5.27 µg/l. All but one of the anaphylactic deaths had tryptase concentrations exceeding that limit. Tryptase was significantly elevated in femoral blood from anaphylactic deaths (p<0.007), compared with the controls. Also, in the cases where death had occurred due to asphyxia tryptase was elevated in femoral blood (p<0.04). A significant difference in tryptase concentrations was seen between blood from the heart and the femoral vessels (p<0.02) in the whole material (n=44). Tryptase concentrations in femoral blood were not influenced by prone position at death, or resuscitation efforts. It is concluded that asphyxia premortem seems to affect tryptase concentrations, that postmortem tryptase measurements should be done in serum from femoral blood, and that the normal upper limit, covering 95%, is 44.3 µg/l. © 2006 Springer-Verlag.

Place, publisher, year, edition, pages
2007. Vol. 121, no 4, 275-280 p.
Keyword [en]
Allergy, Anaphylaxis, Asphyxia, Mast cell, Postmortem, Tryptase
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-49233DOI: 10.1007/s00414-006-0101-2OAI: diva2:270129
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2010-05-24

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Edston, ErikEriksson, Olle
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