The patient’s serum tryptase level was elevated immediately following a bee sting and remained elevated one week later [Image: Aaron Burden on Unsplash]
Measurement of mast cell tryptase is a vital yet underused tool in the assessment of severe allergic and mast cell disorders. This article summarises the causes of elevated serum tryptase, indications for testing and interpretation of results
References
1. Sala-Cunill A, Cardona V, Labrador-Horrillo M, et al. Usefulness and limitations of sequential serum tryptase for the diagnosis of anaphylaxis in 102 patients. Int Arch Allergy Immunol 2013;160(2):192–99.
2. Chollet MB, Akin C. Hereditary alpha tryptasemia is not associated with specific clinical phenotypes. J Allergy Clin Immunol 2022;149(2):728–35.e2.
3. Lee AYS. Elevated serum tryptase in non-anaphylaxis cases: A concise review. Int Arch Allergy Immunol 2020;181(5):357–64.
4. Gulen T, Akin C, Bonadonna P, et al. Selecting the right criteria and proper classification to diagnose mast cell activation syndromes: A critical review. J Allergy Clin Immunol Pract 2021;9(11):3918–28.
![Barbara Fountain, editor of New Zealand Doctor Rata Aotearoa, and Paul Hutchison, GP and senior medical clinician at Tāmaki Health [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/Barbara%20Fountain%2C%20editor%20of%20New%20Zealand%20Doctor%20Rata%20Aotearoa%2C%20and%20Paul%20Hutchison%2C%20GP%20and%20senior%20medical%20clinician%20at%20T%C4%81maki%20Health%20CR%20Simon%20Maude.jpg?itok=-HbQ1EYA)
![Lori Peters, NP and advanced health improvement practitioner at Mahitahi Hauora, and Jasper Nacilla, NP at The Terrace Medical Centre in Wellington [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/2.%20Lori%20Peters%2C%20NP%20and%20advanced%20HIP%20at%20Mahitahi%20Hauora%2C%20and%20Jasper%20Nacilla%2C%20NP%20at%20The%20Terrace%20Medical%20Centre%20in%20Wellington%20CR%20Simon%20Maude.jpg?itok=sUfbsSF1)
![Ministry of Social Development health and disability coordinator Liz Williams, regional health advisors Mary Mojel and Larah Takarangi, and health and disability coordinators Rebecca Staunton and Myint Than Htut [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/3.%20Ministry%20of%20Social%20Development%27s%20Liz%20Williams%2C%20Mary%20Mojel%2C%20Larah%20Takarangi%2C%20Rebecca%20Staunton%20and%20Myint%20Than%20Htut%20CR%20Simon%20Maude.jpg?itok=9ceOujzC)
![Locum GP Helen Fisher, with Te Kuiti Medical Centre NP Bridget Woodney [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/4.%20Locum%20GP%20Helen%20Fisher%2C%20with%20Te%20Kuiti%20Medical%20Centre%20NP%20Bridget%20Woodney%20CR%20Simon%20Maude.jpg?itok=TJeODetm)
![Ruby Faulkner, GPEP2, with David Small, GPEP3 from The Doctors Greenmeadows in Napier [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/5.%20Ruby%20Faulkner%2C%20GPEP2%2C%20with%20David%20Small%2C%20GPEP3%20from%20The%20Doctors%20Greenmeadows%20in%20Napier%20CR%20Simon%20Maude.jpg?itok=B0u4wsIs)
![Rochelle Langton and Libby Thomas, marketing advisors at the Medical Protection Society [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/6.%20Rochelle%20Langton%20and%20Libby%20Thomas%2C%20marketing%20advisors%20at%20the%20Medical%20Protection%20Society%20CR%20Simon%20Maude.jpg?itok=r52_Cf74)
![Specialist GP Lucy Gibberd, medical advisor at MPS, and Zara Bolam, urgent-care specialist at The Nest Health Centre in Inglewood [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/7.%20Specialist%20GP%20Lucy%20Gibberd%2C%20medical%20advisor%20at%20MPS%2C%20and%20Zara%20Bolam%2C%20urgent-care%20specialist%20at%20The%20Nest%20Health%20Centre%20in%20Inglewood%20CR%20Simon%20Maude.jpg?itok=z8eVoBU3)
![Olivia Blackmore and Trudee Sharp, NPs at Gore Health Centre, and Gaylene Hastie, NP at Queenstown Medical Centre [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/8.%20Olivia%20Blackmore%20and%20Trudee%20Sharp%2C%20NPs%20at%20Gore%20Health%20Centre%2C%20and%20Gaylene%20Hastie%2C%20NP%20at%20Queenstown%20Medical%20Centre%20CR%20Simon%20Maude.jpg?itok=Z6u9d0XH)
![Mary Toloa, specialist GP at Porirua and Union Community Health Service in Wellington, Mara Coler, clinical pharmacist at Tū Ora Compass Health, and Bhavna Mistry, specialist GP at Porirua and Union Community Health Service [Image: Simon Maude]](/sites/default/files/styles/thumbnail_cropped_100/public/2025-03/9.%20Mary%20Toloa%2C%20Porirua%20and%20Union%20Community%20Health%20Service%20in%20Wellington%2C%20Mara%20Coler%2C%20T%C5%AB%20Ora%20Compass%20Health%2C%20and%20Bhavna%20Mistry%2C%20PUCHS%20CR%20Simon%20Maude.jpg?itok=kpChr0cc)