Difference in Central and Peripheral Total Tryptase Concentration/Level in Fatal Anaphylaxis

Postmortem tryptase is an adjunct test to assist in diagnosing fatal anaphylaxis. A series of recent studies have shown that postmortem total tryptase concentrations/levels varied between central and peripheral blood samples in normal population. However, it is unclear whether it also varies between central and peripheral blood samples in fatal anaphylaxis. We document a death from anaphylaxis triggered by radiocontrast. Postmortem total tryptase concentrations/levels in arterial and venous central blood collected from the aorta and inferior vena cava were >200 μL/L, whereas arterial and venous peripheral blood collected from femoral artery and veins were ~110 μg/L. This case report provides evidence that postmortem total tryptase concentrations/levels also vary in central and peripheral blood samples in anaphylactic deaths.