Tryptase

The Tryptase test contains 1 test with 1 biomarker.

Brief Description: The Tryptase test is a laboratory assay designed to measure the levels of tryptase in the bloodstream. Tryptase is an enzyme predominantly released from mast cells, which are a type of white blood cell playing a vital role in allergic responses and inflammation. Elevated levels of tryptase can indicate an increased number of mast cells or an activation of these cells in the body.

Also Known As: Tryptase Serum Test, Mast Cell Tryptase Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Tryptase test ordered?

Tryptase testing is not usually requested. Tryptase tests are typically not used to identify anaphylaxis, and mastocytosis is uncommon. When a person exhibits symptoms that could indicate anaphylaxis, a tryptase test may be requested, particularly if the diagnosis is hazy and/or the symptoms are recurrent. Anaphylaxis symptoms can include:

• Flushing
• throat, face, tongue, and/or eye swelling
• reduced blood pressure
• abdominal pain, vomiting, diarrhea, and nausea
• cardiac irregularities
• dizziness or lightheadedness
• breathing issues and wheeze
• Itching, frequently accompanied with hives,
• Loss of consciousness or confusion
• Several of these symptoms are also present in other diseases.

A doctor may also recommend this test if they believe a patient has a mast cell activation problem, cutaneous or systemic mastocytosis, or both. Individuals who have these illnesses may experience many of the same symptoms and signs as those who have severe allergies, but frequently without any obvious triggers, such as exposure to a particular food (like peanuts) or a bee sting. Peptic ulcers, persistent diarrhea, and joint discomfort are just a few of the signs of organ involvement that people with systemic mastocytosis may experience. It's possible for organs like the liver, spleen, or lymph nodes to grow. Skin involvement with rashes or recognizable red, blistering sores is possible.

Once someone passes away, a tryptase test may be requested to assist determine whether anaphylaxis was the cause of death.

What does a Tryptase blood test check for?

Tryptase is an enzyme that is secreted by mast cells when they are triggered as part of a regular immune response as well as in allergic reactions, along with histamine and other substances. The tryptase level in the blood is determined by this test.

Large tissue cells called mast cells can be found all over the body. The epidermis, lining of the intestine and air passages, and bone marrow contain the largest concentrations of them. They have granules in them that store tryptase and histamine among other substances. Mast cells release their contents when they are triggered. The chemicals emitted may result in symptoms ranging from mild to potentially fatal if a person has an excessive number of mast cells or if the cells are improperly triggered.

Tryptase levels in the blood are typically relatively low. The level rises quickly when mast cells are triggered, rising within 15 to 30 minutes, peaking at 1 to 2 hours, and then quickly returning to normal after several hours to a few days. Anaphylaxis, a severe allergic reaction that can result in low blood pressure, hives, severely narrowed airways, and even death, can occur in patients with severe allergies when many mast cells become activated. Those who have anaphylaxis will have very high tryptase levels.

In some situations, people with mast cell activation disorders, in which mast cells become activated without evident allergies or other reasons, will have elevated tryptase levels.

The rare group of diseases known as mastocytosis, which is characterized by an abnormal rise in the number of mast cells, can also cause tryptase levels to rise dramatically and consistently. The skin or various organs in the body may develop an accumulation of these cells.

Those with systemic mastocytosis or a mast cell activation condition may have anaphylaxis and its accompanying symptoms, although cutaneous mastocytosis often only results in skin issues. These symptoms, which are connected to the organs impacted by mast cell buildup, may last for a long time. Systemic mastocytosis can advance slowly or quickly, resulting in organ failure and, in a small percentage of cases, a form of leukemia.

Lab tests often ordered with a Tryptase test:

When a Tryptase test is ordered, it's often part of a broader evaluation for allergic reactions, mast cell disorders, or other related conditions. Here are some tests commonly ordered alongside it:

1. Complete Blood Count (CBC) with Differential:

   • Purpose: To evaluate overall blood health, including white and red blood cells, and platelets.
   • Why Is It Ordered: To assess for eosinophilia (high eosinophil count), which can be associated with allergic conditions and some types of mast cell disorders.

2. Serum IgE Levels:

   • Purpose: To measure the level of immunoglobulin E (IgE), an antibody often elevated in allergic reactions.
   • Why Is It Ordered: To assess for atopy or allergic predisposition, as elevated IgE can be seen in various allergic conditions.

3. Histamine:

   • Purpose: To measure the level of histamine, a chemical released by mast cells during allergic reactions.
   • Why Is It Ordered: To complement tryptase testing, as histamine is another marker of mast cell activation.

4. Liver Function Test:

   • Purpose: To assess liver health.
   • Why Is It Ordered: To evaluate for liver involvement in systemic mast cell disorders.

These tests, when ordered alongside a Tryptase test, provide a comprehensive evaluation of potential allergic reactions, mast cell activation, and related disorders. They are crucial for diagnosing and managing conditions like anaphylaxis, mastocytosis, and other allergic or inflammatory diseases. The specific combination of tests will depend on the individual’s symptoms, clinical presentation, and medical history.

Conditions where a Tryptase test is recommended:

The Tryptase test is primarily ordered when there's suspicion of a systemic allergic reaction or a mast cell disorder. Conditions or scenarios that might necessitate the test include:

• Systemic Anaphylaxis: A severe, potentially life-threatening allergic reaction that affects multiple body systems.
• Systemic Mastocytosis: A condition characterized by an abnormal accumulation of mast cells in the skin, bone marrow, and internal organs.
• Mast Cell Activation Syndrome (MCAS): A condition where mast cells inappropriately release chemicals, resulting in a range of chronic symptoms.

How does my health care provider use a Tryptase test?

Tryptase testing is an effective way to detect mast cell activation. Mast cells are big tissue cells that are most prevalent in the skin, bone marrow, and the walls of the intestine and air passages. Tryptase and other chemicals are released as a normal bodily reaction to injury, but they can also be released in an allergic reaction. Tryptase testing could be applied:

to support an anaphylactic diagnosis. Although a total tryptase test and a histamine test may be requested to assist identify anaphylaxis as the cause of someone's severe symptoms, anaphylaxis is often diagnosed clinically. This is particularly valid if the patient experiences recurrent episodes or if the diagnosis is unclear.

to aid in the identification of a mast cell activation disease or mastocytosis. Mast cells can build up in the skin or in various organs throughout the body in a condition known as mastocytosis, which is a rare group of illnesses.

To assess a person's health and help rule out other disorders that could be the source of comparable symptoms, additional tests might be performed. They may consist of:

• Blood tests using allergen-specific IgE can assist identify the source of an allergic response
• To assess red and white blood cells, perform a complete blood count.
• Detailed Metabolic Panel to assess organ performance
• To rule out a carcinoid tumor that could cause comparable symptoms, such as flushing, diarrhea, and/or wheezing, a 5-hydroxyindoleacetic acid urine test is performed.
• Gastrin test to check for elevated hormone release that could lead to stomach or intestinal ulcers

It is occasionally possible to conduct a tryptase test after a death to assist identify whether anaphylaxis was the cause.

What do my Tryptase test results mean?

The absence of mast cell activation may be the cause of a person's symptoms, as shown by normal tryptase results, or there may be a timing issue with the sample. Tryptase levels often peak in anaphylaxis 1 to 2 hours after symptoms appear. Results may be normal if a sample is taken too early or too late. It can be compared to the tryptase levels if a histamine test is also run. Within a few minutes of anaphylaxis beginning, histamine levels reach their peak and then begin to decline after approximately an hour. It is improbable that a person had anaphylaxis, though it can't be ruled out, if the timing of sample collection was adequate and neither the histamine nor tryptase amounts are excessive.

Anaphylaxis is the most likely diagnosis when a person exhibits acutely high tryptase levels.

Tryptase levels that are consistently high in someone who has mast cell activation symptoms may indicate mastocytosis. This diagnosis needs to be confirmed by additional tests. In people with systemic mastocytosis, tryptase levels are hypothesized to be correlated with the "load" of mast cells.

Most Common Questions About the Tryptase test:

Purpose and Indications for the Tryptase Test

What is the primary purpose of the Tryptase test?

The Tryptase test is primarily used to help diagnose systemic mastocytosis, a disorder caused by too many mast cells, or cells that release chemicals into the blood causing various symptoms. Elevated tryptase levels can indicate the presence of an abnormal number of mast cells.

Why would someone need to take the Tryptase test?

A person may be advised to take the Tryptase test if they show symptoms consistent with systemic mastocytosis or another mast cell disorder. Symptoms might include skin lesions, flushing, abdominal pain, lightheadedness, or anaphylaxis. This test helps confirm the presence of excess mast cells or mast cell activation.

Interpreting the Results

What do the results of the Tryptase test indicate?

The results of the Tryptase test measure the amount of tryptase in the blood. Elevated levels typically suggest mast cell activation or an increased number of mast cells, indicative of conditions like systemic mastocytosis. However, it's essential to interpret the results in the context of clinical symptoms and other diagnostic tests.

If my Tryptase levels are high, does it always mean I have systemic mastocytosis?

No, while elevated tryptase levels can indicate systemic mastocytosis, other conditions or triggers like allergic reactions or certain leukemias might also raise tryptase levels. Clinical correlation and additional diagnostic tests are essential for an accurate diagnosis.

Follow-up and Treatment

What should be the next step after receiving the results of my Tryptase test?

If you have elevated tryptase levels, you should consult a healthcare professional, preferably an allergist or immunologist. They can provide guidance on further tests, monitoring, and potential treatments based on your specific case.

Are there treatments available if I have a confirmed mast cell disorder?

Yes, treatments for mast cell disorders vary depending on the type and severity of the disorder. They might include medications to reduce symptoms, avoid triggers known to activate mast cells, or, in some severe cases, chemotherapy or targeted therapies.

Disease Progression and Complications

Can mast cell disorders lead to severe complications?

Yes, in some cases, mast cell disorders, particularly systemic mastocytosis, can lead to complications such as anaphylaxis, organ damage, or skeletal problems. Regular monitoring and early intervention can help manage the disorder and reduce the risk of complications.

Are there other tests to monitor mast cell disorders?

Yes, if someone is diagnosed with a mast cell disorder, various tests, including bone marrow biopsy, genetic testing, and additional blood tests, might be recommended to assess the severity and extent of the disease.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.