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Drug-induced bronchospasm
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
K Suresh Babu, Jaymin Morjaria
Tryptase is a valuable marker of systemic mast-cell degranulation.66 Tryptase exists in the α and β forms, of which the β form is a measure of mast-cell activation, and concentrations are raised in mast-cell-dependent anaphylactic (IgE-mediated) and anaphylactoid (non-IgE-mediated) reactions.65 The half-life of tryptase in plasma is 2 hours and the enzyme is not prone to rapid degradation. For these reasons, measurement of tryptase concentrations is favoured over measurement of serum histamine. Serum samples between 30 minutes and 5 hours after the event, when compared with baseline concentrations taken weeks after, may confirm or exclude the diagnosis.5 However, despite the usefulness of this test in assessing both immune and non-immune drug reactions, it is important to note that β tryptase concentrations can be normal if the reaction does not involve haemodynamic changes.67
A comprehensive summary of disease variants implicated in metal allergy
Published in Journal of Toxicology and Environmental Health, Part B, 2022
The most common form of anaphylaxis is mediated by type I hypersensitivity mechanisms. In sensitized individuals, systemic antigen exposure triggers IgE-dependent activation of mast cells and basophils, leading to the release of many unique preformed mediators such as tryptase, histamine, and chemokines with various physiological functions (Loverde et al. 2018). The actions of these molecules are responsible for the subsequent emergence prototypical anaphylactic symptoms, which range from eruption of widespread urticarial lesions and angioedema in the skin, to profound bronchoconstriction with potential for respiratory insufficiency, and severe hypotension that lead to dizziness and syncope (Pawankar et al. 2013). In some cases, symptoms may be mild and readily managed with minimal intervention; comparatively, catastrophic reactions may also ensue, requiring immediate medical attention to monitor and treat life-threatening symptoms of anaphylaxis (Tomar and Hogan 2020). Pawankar et al. (2013) estimated that the lifetime occurrence of anaphylaxis ranges from 0.05–2% in the general population. Some of the major causative agents of anaphylaxis include pharmaceutical agents, insect venom, and food allergens (Muñoz-Cano et al. 2016). A small number of case reports also described the induction of anaphylactic responses in metal-sensitive subjects following various exposure conditions.