Basal serum tryptase is not a risk factor for immediate-type drug hypersensitivity during childhood.
High serum basal tryptase (sBT) levels have been identified as a risk factor for both venom- and food-induced severe allergic reactions. The aim of this study was to compare sBT levels in children with different severity of actual drug hypersensitivity reactions (DHRs) with those of age- and sex-matched controls without any history of DHRs.



Patients between 0 and 18 years of age with a history of immediate-type DHRs manifested in 0-6 h after the culprit drug intake were included. Following ENDA (European Network for Drug Allergy) inquiries, patients were evaluated with skin and/or provocation tests to define the actual drug-hypersensitive patients. Serum BT levels were determined for both patients and controls.



Of 345 children, 106 patients (30.7%) [(58.5% male), median age (interquartile range) 8.0 years (4.2-12.2)] were diagnosed as drug hypersensitive. Ninety-eight controls were also included. The sBT levels of drug-hypersensitive patients with and without anaphylaxis and the control group were similar [2.6 (2.0-3.6) μg/l vs. 2.8 (1.6-4.3) μg/l vs. 2.6 (1.8-3.6) μg/l, respectively, (p > 0.05)]. The sBT levels of the patients with sole cutaneous symptoms 2.8 (1.6-4.3) μg/l, mild anaphylaxis 3.0 (1.9-4.9) μg/l, and moderate-to-severe anaphylaxis 2.6 (2.0-3.6) μg/l were also comparable (p > 0.05). The onset of DHRs [those occurring in 1 h (n = 87) or in 1-6 h (n = 19) after the drug intake], positive results with skin tests with the culprit drug, or the classification of the patients according to different age groups [(0-2 years), (2-6 years), (6-12 years), (12-18 years)] did not correlate with sBT levels.



The sBT levels in children with actual drug hypersensitivity would not be a risk factor for severe systemic reactions on the contrary to children with allergic reactions to food or insect venom.
Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey.
Ozlem
O
Cavkaytar
Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey.
Betul
B
Karaatmaca
Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey.
Ebru
E
Arik Yilmaz
Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey.
Umit M
UM
Sahiner
Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey.|Division of Pediatric Allergy, Koc University School of Medicine, Istanbul, Turkey.
Cansın
C
Sackesen
Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey.
Bulent E
BE
Sekerel
Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey. ozgeusoyer@gmail.com.
Ozge
O
Soyer
D000777:Anesthetics / Q000009:adverse effects* / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012882:Skin Tests; D053802:Tryptases / Q000097:blood
D000777:Anesthetics; D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D053802:Tryptases
Anaphylaxis; drug hypersensitivity; pediatrics; tryptase