We know high levels of tryptase are associated with mast cell activation. What can cause low levels of tryptase ?
Scenario: 24 year old male, presents with rash all over body rasied rashes with itching , No shortness of breath or lips swelling or dry throat. Patient stable and says has been having these symptoms for about 3 months. Takes cold shower and after a day rash settles down. Blood tests show Tryptase low, IgE normal, all blood parameteres normal except RBC high, MCV low ,MCH low ,hb normal. Pt goes to gym and two months back used Anabolic steroids . Which blood tests needs to be done further to rule out any pathology ?
I think this patient probably has physical urticaria. Tryptase level measurement didn't indicated. It usually elevated after sever prophylaxis and in brief period of time (6 hour). It is better to recommended avoidance from using anabolic drug and sever exercise accompanying with prescription of one of second generation antihistamine with follow up.
Elevated Tryptase level and not it's dcrease is important in diagnosis of mast cell activation disorders .Therefore decreased level of tryptase has no clinical importance.
in this case patient will need to be done the platelet count test