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아나필락시스 쇼크의 사후 진단에서 비만세포 트립신분해효소검사의 유용성

Usefulness of Serum Mast Cell Tryptase Analysis in Postmortem Diagnosis of Anaphylactic Shock

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초록

Anaphylactic deaths are frequently observed at autopsies. Since death associated with medical practice has become social concern, the identification of anaphylactic shock is an important part of forensic medicine. However, autopsy findings of anaphylactic shock are usually non-specific; therefore, the diagnosis of anaphylactic shock must be inferred from collecting data on the past history of the deceased, circumstances of death, and negative autopsy findings. The analysis of serum mast cell tryptase level is a well-known, useful ancillary test for the diagnosis of anaphylactic shock, but is not widely used in daily practice in Korea. We recently encountered 2autopsy cases of anaphylactic shock and confirmed that analysis of serum mast cell tryptase level was useful for the diagnosis of anaphylactic shock. In this report, we present these 2 autopsy cases of anaphylactic shock, with literature review of the usefulness and limitations of serum mast cell tryptase analysis.

Abstract

Anaphylactic deaths are frequently observed at autopsies. Since death associated with medical practice has become social concern, the identification of anaphylactic shock is an important part of forensic medicine. However, autopsy findings of anaphylactic shock are usually non-specific; therefore, the diagnosis of anaphylactic shock must be inferred from collecting data on the past history of the deceased, circumstances of death, and negative autopsy findings. The analysis of serum mast cell tryptase level is a well-known, useful ancillary test for the diagnosis of anaphylactic shock, but is not widely used in daily practice in Korea. We recently encountered 2autopsy cases of anaphylactic shock and confirmed that analysis of serum mast cell tryptase level was useful for the diagnosis of anaphylactic shock. In this report, we present these 2 autopsy cases of anaphylactic shock, with literature review of the usefulness and limitations of serum mast cell tryptase analysis.

참고문헌 (8)

  1. Da Broi U, "Post-mortem diagnosis of anaphylaxis: a difficult task in forensic medicine", Forensic Sci Int, 204, pp.1~5 (2011)
  2. Pumphrey RS, "Postmortem findings after fatal anaphylactic reactions", J Clin Pathol, 53, pp.273~276 (2000)
  3. DiMaio VJ, "Forensic pathology", pp.468~469 (2001), CRC Press
  4. Byard RW, "An analysis of possible mechanisms of unexpected death occurring in Hydatid diease (echinococcosis)", J Forensic Sci, 54, pp.919~922 (2009)
  5. Nara A, "Death due to blood transfusion-induced anaphylactic shock: a case report", Leg Med (Tokyo), 12, pp.148~150 (2010)
  6. Belton AL, "Fatal anaphylactic reaction to hair dye", Am J Forensic Med Pathol, 18, pp.290~292 (1997)
  7. Mayer DE, "Usefulness of post mortem determination of serum tryptase, histamine and diamine oxidase in the diagnosis of fatal anaphylaxis", Forensic Sci Int, 212, pp.96~101 (2011)
  8. Edston E, "beta-Tryptase measurements post-mortem in anaphylactic deaths and in controls", Forensic Sci Int, 93, pp.135~142 (1998)

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