Premium
Postmortem Serum Tryptase Levels with Special Regard to Acute Cardiac Deaths
Author(s) -
Xiao Ning,
Li DongRi,
Wang Qi,
Zhang Fu,
Yu YanGeng,
Wang HuiJun
Publication year - 2017
Publication title -
journal of forensic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.715
H-Index - 96
eISSN - 1556-4029
pISSN - 0022-1198
DOI - 10.1111/1556-4029.13420
Subject(s) - tryptase , medicine , receiver operating characteristic , autopsy , anaphylaxis , gastroenterology , group b , mast cell , cardiology , pathology , immunology , allergy
An elevated serum tryptase concentration is considered a specific marker for systemic mast cell activation, a central feature of anaphylaxis. However, in some cases of acute cardiovascular death, high concentrations of serum tryptase are also observed. We compared the postmortem serum tryptase concentrations in 74 cases assigned to the following four groups: anaphylactic deaths (Group A, n = 20), acute cardiac deaths (Group ACD , n = 30), acute dissecting aneurysm ruptures (Group ADA , n = 10), and controls (Group C, n = 14). Additionally, the cutoff between Group A and the other groups was calculated using receiver‐operating characteristic ( ROC ) curve analysis. Tryptase concentrations were markedly elevated in Group A ( p < 0.001), Group ACD ( p = 0.015), and Group ADA ( p = 0.005). The optimal cutoff was 43 ng/mL, the sensitivity was 90%, and the specificity was 98%. While elevated concentrations of tryptase were noted in practical autopsy cases, due attention should be paid to the differential diagnosis between anaphylactic and acute cardiovascular deaths.