ArticleBJA open2024
Paediatric perioperative hypersensitivity: the performance of the current consensus formula and the effect of uneventful anaesthesia on serum tryptase.
Article in BJA open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Under the Drapes: Unmasking the Mechanisms and Clinical Diagnosis of Perioperative Hypersensitivity.Current allergy and asthma reports · 2026Review
- Understanding Tryptase Physiology, Clinical Significance, and Diagnostic Applications: Where Do We Stand?Biomolecules · 2026Review
- Diagnostic Performance of Biomarkers for Perioperative Hypersensitivity Reactions in Adults: A Systematic Review and Meta-Analysis on Tryptase and Histamine Dosing.Diagnostics (Basel, Switzerland) · 2026Review
- A 5-year experience of paediatric perioperative hypersensitivity at a tertiary hospital anaesthetic allergy service in Sydney, Australia.British journal of anaesthesia · 2025Article
- Pediatric anaphylaxis in the emergency department: Performances of dynamic tryptase measurement.The journal of allergy and clinical immunology. Global · 2025Article
- Article
- Serum tryptase changes in children with suspected perioperative hypersensitivity. Comment onBJA open · 2024Article
- Causative agent for perioperative anaphylaxis in a child with autism successfully identified using the intradermal test under general anesthesia.JA clinical reports · 2024Article
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Paired sampling of acute (aST) and basal (bST) serum tryptase has been recommended when investigating patients with a suspected perioperative hypersensitivity (POH) reaction. In the current consensus formula, an aST value exceeding (1.2×bST+2) confirms mast cell activation. The current consensus formula has been validated in adults but not in children. Methods: We prospectively included 96 children who underwent uneventful anaesthesia and sampled serum tryptase at baseline and 60-90 min after induction. Tryptase changes were then compared with those in 94 children with suspected POH who were retrospectively included from four reference centres in Belgium, France, and Denmark. Results: We observed a median decrease in serum tryptase during uneventful anaesthesia of 0.41 μg L Conclusions: This is the first study suggesting the need for an adjusted formula in children to identify perioperative mast cell activation as tryptase is significantly lowered during uneventful anaesthesia. We propose a new formula (aST>bST+0.71) which performs significantly better than the current consensus formula in our multicentric paediatric population.
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