Older patients experienced greater rate of tryptase during anaphylaxis
Older patients who experienced anaphylaxis related to suspected allergy had a greater rate and median of tryptase compared with younger patients, according to research presented at the European Academy of Allergy and Clinical Immunology annual congress in Copenhagen, Denmark.
Researchers in Pamplona, Spain, conducted a retrospective review of 1,505 tryptase determinations in patients attending the Navarre Health System hospitals emergency department between 2009 and 2012 for suspected allergy. They included patients who met criteria for anaphylaxis.
Patients were divided into three groups: aged 15 years and younger (group A), aged 16 to 64 years (group B), and aged 65 years and older (group C). Analyses were conducted using chi-square test on positive tryptase determination rates (>11.4 mcg/L) and the Kruskall-Wallis test on median of tryptase values during anaphylactic event and median duration of symptoms at sample collection. A receiver-operating characteristic (ROC) curve was used to determine the median of tryptase.
Three hundred seventy-six episodes of anaphylaxis were identified in 55, 270 and 51 patients in groups A, B and C, respectively. Group A had 32% rate of positive tryptase; group B, 59.4%; and group C, 78.8% (P<.001). Group A displayed a median of tryptase of 7.98 mcg/L (1-39.7mcg/L); group B, 11.25 mcg/L (1.57-98.6 mcg/L); and group C, 17 mcg/L (4.78-94.3 mcg/L; P<.001).
Median durations of symptoms were 1 hour (0.25-24 hours), group A; 1.5 hours (0.33-17 hours), group B; and 2 hours (0.1-6 hours), group C; (P>.05). Optimal cut-off points using ROC were 7.19 mcg/L, group A; 7.56 mcg/L, group B; and 13.3 mcg/L, group C.
“The rate and median of tryptase during anaphylaxis increase with the age of the patients,” the researchers concluded. “Specific cut-off points in acute tryptase determinations are needed to accurately assess patients of different ages.”
For more information:
Arroabarren E. #25. Presented at: European Academy of Allergy and Clinical Immunology annual congress 2014; June 7-11; Copenhagen, Denmark.
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