TY - JOUR
T1 - Post mortem tryptase : a review of literature on its use, sampling and interpretation in the investigation of fatal anaphylaxis
AU - Garland, Jack
AU - Ondruschka, Benjamin
AU - Broi, Ugo Da
AU - Palmiere, Cristian
AU - Tse, Rexson
PY - 2020
Y1 - 2020
N2 - Post mortem tryptase is a commonly-used ancillary test in the investigation of possible anaphylactic deaths. Ante mortem tryptase interpretation differs from post mortem interpretation due to differing priorities, biochemical behaviours and capacity for follow-up. Additionally, post mortem tryptase sampling site, method and even cut-off levels are not standardised between facilities. This review of the literature investigates the existing research and recommendations on the use of post mortem tryptase in suspected anaphylactic deaths. Currently, autopsy recommendations suggest early sampling, standardised sampling technique with clamping of and aspiration from the femoral vein, and for the results to be interpreted within the wider autopsy and clinical context. Areas in need of further research include the effects of cytolysis on tryptase levels and studies to stratify differing tryptase levels based on type of death and anaphylactic trigger.
AB - Post mortem tryptase is a commonly-used ancillary test in the investigation of possible anaphylactic deaths. Ante mortem tryptase interpretation differs from post mortem interpretation due to differing priorities, biochemical behaviours and capacity for follow-up. Additionally, post mortem tryptase sampling site, method and even cut-off levels are not standardised between facilities. This review of the literature investigates the existing research and recommendations on the use of post mortem tryptase in suspected anaphylactic deaths. Currently, autopsy recommendations suggest early sampling, standardised sampling technique with clamping of and aspiration from the femoral vein, and for the results to be interpreted within the wider autopsy and clinical context. Areas in need of further research include the effects of cytolysis on tryptase levels and studies to stratify differing tryptase levels based on type of death and anaphylactic trigger.
UR - https://hdl.handle.net/1959.7/uws:65715
U2 - 10.1016/j.forsciint.2020.110415
DO - 10.1016/j.forsciint.2020.110415
M3 - Article
SN - 0379-0738
VL - 314
JO - Forensic Science International
JF - Forensic Science International
M1 - 110415
ER -