II. Indications
-
Anaphylaxis confirmation in unclear cases
- Levels rise 30 minutes after onset and peak at 1-2 hours of Anaphylaxis
- Serum Tryptase is often normal in food-related reactions
- Mastocytosis (Clonal Mast Cell disease)
III. Physiology
- Tryptase is a marker of systemic Mast Cell degranulation
- Tryptases are a family of neutral Serine proteases, enzymes with activity similar to trypsin
- Tryptases are primarily found in the secretory granules of Mast Cells
- Tryptases are released during Mast Cell degranulation (e.g. Anaphylaxis)
IV. Causes
- Episodic Serum Tryptase increase
- Persistent Serum Tryptase increase (>8 ng/ml)
- Mastocytosis
- Hereditary Alpha-Tryptasemia
- Other Causes of Elevated Serum Tryptase
- Acute Myelocytic Leukemia
- Myelodysplastic Syndrome
- Hypereosinophilic Syndrome (FLP1L1-PDGFRA mutation)
- End Stage Renal Disease
V. Labs
-
Anaphylaxis
- Obtain level on presentation, within 1-2 hours, and again in 24 hours after presentation
- Levels consistent with systemic Mast Cell activation in Anaphylaxis
- Serum Tryptase>11.4 ng/ml OR
- Serum Tryptase increase over baseline of 20% PLUS 2 ng/ml
-
Mastocytosis
- Serum Tryptase >20 ng/ml (systemic mastocytocytosis)
VI. References
- Bakerman (2014) ABCs of Interpretive Laboratory Data, p. 544
- Golden (2024) Ann Allergy Asthma Immunol 132(2): 124-76 +PMID: 38108678 [PubMed]
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Related Studies
| Definition (CSP) | E.C. 3.4.21.59. |
| Definition (MSH) | A family of neutral serine proteases with TRYPSIN-like activity. Tryptases are primarily found in the SECRETORY GRANULES of MAST CELLS and are released during mast cell degranulation. |
| Concepts | Amino Acid, Peptide, or Protein (T116) , Enzyme (T126) |
| MSH | D053802 |
| SnomedCT | 115522006, 130616001 |
| LNC | LP17650-0, MTHU003528 |
| English | Tryptase, Tryptases, TRYPTASE, mast cell protease II, lung tryptase, Tryptase -RETIRED-, Tryptases [Chemical/Ingredient], tryptase mast cell, mast cell tryptase, tryptase, Tryptase (substance) |
| Portuguese | Triptase, Triptases |
| Spanish | Triptasa, Triptasas, triptasa - RETIRADO -, triptasa (sustancia), triptasa - RETIRADO - (concepto no activo), triptasa |
| Russian | БЕТА-ТРИПТАЗЫ, ТРИПТАЗЫ, BETA-TRIPTAZY, TRIPTAZY |
| Italian | Triptasi |
| German | Tryptase, Tryptasen |
| French | Tryptase, Tryptases |
| Finnish | Tryptaasit |
| Czech | tryptasy, tryptasa |
| Japanese | トリプターゼ, 肥満細胞トリプターゼ |
| Swedish | Tryptaser |
| Polish | Tryptazy |
Ontology: Serum tryptase level (C1318656)
| Concepts | Laboratory Procedure (T059) |
| SnomedCT | 408177002 |
| English | Serum tryptase level (procedure), Serum tryptase level, Serum tryptase measurement |
| Spanish | determinación de nivel de triptasa en suero, determinación de nivel sérico de triptasa (procedimiento), determinación de nivel sérico de triptasa |
