NCJ Number
130217
Journal
Journal of Forensic Sciences Volume: 36 Issue: 3 Dated: (May 1991) Pages: 857-865
Date Published
1991
Length
9 pages
Annotation
Nineteen anaphylactic death cases are reported using mast cell derived tryptase levels and allergen specific immunoglobulin E (IgE) antibody levels for diagnostic criteria.
Abstract
Single sera were obtained prior to or within 24 hours after death from 19 anaphylaxis victims who reacted to either Hymenoptera stings, foods, or diagnostic or therapeutic agents. Tryptase levels were measured by enzyme linked immunoabsorbent assay (ELISA) and IgE antibodies by solid-phase radioimmunoassay. Elevated serum tryptase levels were found in nine of the nine Hymenoptera sting fatalities, in six of eight food-induced fatalities, and in two of two reactions to diagnostic and therapeutic agents. Tryptase levels were normal in the 57 sequential sera obtained from postmortem from 6 control patients. Serum IgE antibodies were elevated in five of the nine Hymenoptera sting fatalities and in eight of the eight food fatalities. Assays were unavailable for the diagnostic reagents. If elevated, the victims' serum IgE antibodies to food could be used to identify allergens in uneaten portions of foods consumed shortly before the anaphylactic reaction. IgE antibodies were moderately stable during storage in anticoagulants at room temperature for up to 11 weeks. These findings indicate that elevated mast cell derived tryptase levels in postmortem sera reflect antemortem cell activation and can be used as a marker for fatal anaphylaxis. Assays for IgE antibodies to relevant allergens can provide evidence for antemortem sensitization. 1 table, 2 figures, and 17 references (Author abstract modified)