{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T17:41:48Z","timestamp":1789062108434,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,3,22]],"date-time":"2012-03-22T00:00:00Z","timestamp":1332374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2012,5]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Risk indicators of indolent systemic mastocytosis (\n ISM<\/jats:styled-content>\n ) in adults with clinical suspicion of\n ISM<\/jats:styled-content>\n without accompanying skin lesions [urticaria pigmentosa (\n UP<\/jats:styled-content>\n )] are lacking. This study aimed at creating a decision tree using clinical characteristics, serum tryptase, and the urinary histamine metabolites methylimidazole acetic acid (\n MIMA<\/jats:styled-content>\n ) and methylhistamine (\n MH<\/jats:styled-content>\n ) to select patients for bone marrow investigations to diagnose\n ISM<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Retrospective data analysis of all adults, in whom bone marrow investigations were performed to diagnose\n ISM<\/jats:styled-content>\n , was carried out.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In total, 142 patients were included.\n SM<\/jats:styled-content>\n was absent in all 44 patients with tryptase <10\u00a0\u03bcg\/l, in 45 of 98 (46%) patients with tryptase \u226510\u00a0\u03bcg\/l and in 18 of 52 patients (35%) with tryptase >20\u00a0\u03bcg\/l. Above 43\u00a0\u03bcg\/l, all patients had\n ISM<\/jats:styled-content>\n (\n n<\/jats:italic>\n \u00a0=\u00a011). Male gender, insect venom anaphylaxis as presenting symptom, tryptase,\n MIMA<\/jats:styled-content>\n , and\n MH<\/jats:styled-content>\n were independent\n ISM<\/jats:styled-content>\n predictors. If tryptase was \u226510\u00a0\u03bcg\/l, the diagnostic accuracy of\n MIMA<\/jats:styled-content>\n and\n MH<\/jats:styled-content>\n was high (areas under the\n ROC<\/jats:styled-content>\n curve 0.92).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In suspected patients without\n UP<\/jats:styled-content>\n , the\n ISM<\/jats:styled-content>\n risk is very low (if present at all) if tryptase is <10\u00a0\u03bcg\/l. If tryptase is \u226510\u00a0\u03bcg\/l, this risk depends on\n MIMA<\/jats:styled-content>\n and\n MH<\/jats:styled-content>\n , being low if these are normal, but high if these are elevated. Male gender and insect venom anaphylaxis are additional risk indicators. We recommend refraining from bone marrow examinations in suspected patients without\n UP<\/jats:styled-content>\n if tryptase is <10\u00a0\u03bcg\/l. Our results question the reliability of the minor diagnostic\n W<\/jats:styled-content>\n orld\n H<\/jats:styled-content>\n ealth\n O<\/jats:styled-content>\n rganization criterion of tryptase >20\u00a0\u03bcg\/l.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/j.1398-9995.2012.02809.x","type":"journal-article","created":{"date-parts":[[2012,3,23]],"date-time":"2012-03-23T02:38:44Z","timestamp":1332470324000},"page":"683-690","source":"Crossref","is-referenced-by-count":57,"title":["Tryptase and histamine metabolites as diagnostic indicators of indolent systemic mastocytosis without skin lesions"],"prefix":"10.1111","volume":"67","author":[{"given":"J. J.","family":"van Doormaal","sequence":"first","affiliation":[{"name":"Departments of Allergology University Medical Center Groningen University of Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"van der Veer","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine University Medical Center Groningen University of Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. C.","family":"van Voorst Vader","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Medical Center Groningen University of Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. M.","family":"Kluin","sequence":"additional","affiliation":[{"name":"Department of Pathology University Medical Center Groningen University of Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. B.","family":"Mulder","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine University Medical Center Groningen University of Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"van der Heide","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine University Medical Center Groningen University of Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Arends","sequence":"additional","affiliation":[{"name":"Department of Reumatology and Clinical Immunology University Medical Center Groningen University of Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. C.","family":"Kluin\u2010Nelemans","sequence":"additional","affiliation":[{"name":"Department of Hematology University Medical Center Groningen University of Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. N. G.","family":"Oude Elberink","sequence":"additional","affiliation":[{"name":"Departments of Allergology University Medical Center Groningen University of Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. G. R.","family":"de Monchy","sequence":"additional","affiliation":[{"name":"Departments of Allergology University Medical Center Groningen University of Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,3,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2004.02.045"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2362.2007.01807.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(99)70184-3"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.11558"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198312293092603"},{"key":"e_1_2_8_7_1","first-page":"1","article-title":"Cutaneous and systemic mastocytosis in adults. A clinical, histopathological and immunological evaluation in relation to histamine metabolism","volume":"115","author":"Olafsson JH","year":"1985","journal-title":"Acta Derm Venereol Suppl (Stockh)"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02007796"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.124511"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.1998.02514.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2007.11.003"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0009-8981(81)90150-9"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0378-4347(00)84373-X"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01993171"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0009-8981(82)90247-9"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02142572"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.92.23.10560"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19981115)83:10<2120::AID-CNCR10>3.0.CO;2-C"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mrfmmm.2004.08.015"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1373\/49.3.433"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/39.4.561"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19980430)17:8<857::AID-SIM777>3.0.CO;2-E"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2009.08.027"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1159\/000085563"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-04-015545"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000048184"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01972348"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/85.5.1185"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.2217\/pgs.09.26"},{"key":"e_1_2_8_30_1","first-page":"225","article-title":"[Interactions between ethanol and histamine]","volume":"23","author":"Chrostek L","year":"2007","journal-title":"Pol Merkur Lekarski"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/34.2.141"}],"container-title":["Allergy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1398-9995.2012.02809.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1398-9995.2012.02809.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T22:07:25Z","timestamp":1698703645000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1398-9995.2012.02809.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,3,22]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2012,5]]}},"alternative-id":["10.1111\/j.1398-9995.2012.02809.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1398-9995.2012.02809.x","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.717968004.793467655","asserted-by":"object"}]},"ISSN":["0105-4538","1398-9995"],"issn-type":[{"value":"0105-4538","type":"print"},{"value":"1398-9995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,3,22]]}}}