Postmortem Serum Tryptase Levels with Special Regard to Acute Cardiac Deaths.
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.
Department of Forensic Medicine, Southern Medical University, 1838# Guangzhou Avenue North, Guangzhou, China, 510000.
Ning
N
Xiao
Department of Forensic Medicine, Southern Medical University, 1838# Guangzhou Avenue North, Guangzhou, China, 510000.
Dong-Ri
DR
Li
Department of Forensic Medicine, Southern Medical University, 1838# Guangzhou Avenue North, Guangzhou, China, 510000.
Qi
Q
Wang
Key Laboratory of Forensic Pathology, Ministry of Public Security, People's Republic of China, Beijiaochangheng Road 3#, Yuexiu District, Guangzhou, China, 510050.
Fu
F
Zhang
Key Laboratory of Forensic Pathology, Ministry of Public Security, People's Republic of China, Beijiaochangheng Road 3#, Yuexiu District, Guangzhou, China, 510050.
Yan-Geng
YG
Yu
Department of Forensic Medicine, Southern Medical University, 1838# Guangzhou Avenue North, Guangzhou, China, 510000.
Hui-Jun
HJ
Wang
D054058:Acute Coronary Syndrome / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000707:Anaphylaxis / Q000097:blood*; D000784:Aortic Dissection / Q000097:blood; D017542:Aneurysm, Ruptured / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity; D053802:Tryptases / Q000097:blood*
D053802:Tryptases
acute cardiovascular death; anaphylactic death; cutoff; forensic science; postmortem serum tryptase