{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T10:30:23Z","timestamp":1790505023149,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T00:00:00Z","timestamp":1639440000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Serum total tryptase has been shown to increase during acute allergic reactions (acute tryptase, T<jats:sub>A<\/jats:sub>); however, few studies have investigated the values of T<jats:sub>A<\/jats:sub> or a combination of T<jats:sub>A<\/jats:sub> and baseline tryptase (T<jats:sub>B<\/jats:sub>) to discriminate positive from negative testing in perioperative hypersensitivity reaction (POH) allergy work\u2010up. The aim of this study was to determine the diagnostic performance of T<jats:sub>A<\/jats:sub> in order to differentiate positive from negative allergy testing suspected POH and analyse the diagnostic performance of serial tryptase levels using several formulas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients from the University hospital of Montpellier and Strasbourg, France, who presented with suspected POH and underwent complete drug allergy work\u2010up between March 2011 and December 2019 with available T<jats:sub>A<\/jats:sub> and T<jats:sub>B<\/jats:sub> were included. Four formulas, including a change in T<jats:sub>A<\/jats:sub>\u00a0&gt;\u00a011 (F1), or &gt;2\u00a0+\u00a01.2\u00a0\u00d7\u00a0T<jats:sub>B<\/jats:sub> (F2), or &gt;3\u00a0+\u00a0T<jats:sub>B<\/jats:sub> (F3), or &gt;120%T<jats:sub>B<\/jats:sub> (F4), were applied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and sixty\u2010two patients were included, and 131 of them (80.8%) had Grade III or IV reactions. Ninety patients had positive allergy testing. The optimal cut\u2010off value of T<jats:sub>A<\/jats:sub> to distinguish positive from negative allergy testing patients was 9.8\u00a0\u03bcg\/L with an AUC of 0.817 (95% CI: 0.752\u20130.882, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). The 93% PPV threshold for T<jats:sub>A<\/jats:sub> was 33\u00a0\u03bcg\/L (95.8% specificity). Paired tryptase levels according to formulas F2 and F3 yielded the highest Youden index (0.54 and 0.53, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The optimal cut\u2010off point for T<jats:sub>A<\/jats:sub> for distinguishing positive from negative allergy testing suspected POH was 9.8\u00a0\u03bcg\/L. T<jats:sub>A<\/jats:sub> value of 33\u00a0\u03bcg\/L was required to achieve &gt;90% PPV.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cea.14040","type":"journal-article","created":{"date-parts":[[2021,11,6]],"date-time":"2021-11-06T05:18:20Z","timestamp":1636175900000},"page":"334-344","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Diagnostic performance of serial serum total tryptase measurement to differentiate positive from negative allergy testing among patients with suspected perioperative hypersensitivity"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9091-7370","authenticated-orcid":false,"given":"Witchaya","family":"Srisuwatchari","sequence":"first","affiliation":[{"name":"Division of Allergy Department of Pulmonology H\u00f4pital Arnaud de Villeneuve University Hospital of Montpellier Univ Montpellier  Montpellier France"},{"name":"Division of Allergy and Immunology 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