Journal List > Korean J Leg Med > v.37(2) > 1004726

Korean J Leg Med. 2013 May;37(2):73-77. Korean.
Published online May 28, 2013.
Copyright © 2013 The Korean Society for Legal Medicine
Usefulness of Serum Mast Cell Tryptase Analysis in Postmortem Diagnosis of Anaphylactic Shock
Jong-Pil Park,1 Minsung Choi,1 Seong Ho Kim,1 Seon Jung Jang,2 and Hyoung-Joong Kim1
1Division of Forensic Medicine, National Forensic Service, Seoul, Korea.
2Department of Forensic Medicine, Korea University College of Medicine, Seoul, Korea.

Corresponding author (Email: )
Received February 01, 2013; Revised April 19, 2013; Accepted May 14, 2013.


Anaphylactic deaths are frequently observed at autopsies. Since death associated with medical practice has become social concern, the identification of anaphylactic shock is an important part of forensic medicine. However, autopsy findings of anaphylactic shock are usually non-specific; therefore, the diagnosis of anaphylactic shock must be inferred from collecting data on the past history of the deceased, circumstances of death, and negative autopsy findings. The analysis of serum mast cell tryptase level is a well-known, useful ancillary test for the diagnosis of anaphylactic shock, but is not widely used in daily practice in Korea. We recently encountered 2 autopsy cases of anaphylactic shock and confirmed that analysis of serum mast cell tryptase level was useful for the diagnosis of anaphylactic shock. In this report, we present these 2 autopsy cases of anaphylactic shock, with literature review of the usefulness and limitations of serum mast cell tryptase analysis.

Keywords: Anaphylaxis; Autopsy; Tryptase


Fig. 1
Autopsy findings of case 1. Sting injury, edema and erythema in right cheek (a), Edema of laryngopharynx (b), Edema and congestion of both lungs (c, d)
Click for larger image

Fig. 2
Autopsy findings of case 2. Edema of laryngopharynx (a), Edema and congestion of both lungs (b), Severe obstruction of coronary artery (c), Old scar formation of myocardium (d)
Click for larger image


Table 1
1. Brief Summary of Case 1 and 2
Click for larger image

1. Da Broi U, Moreschi C. Post-mortem diagnosis of anaphylaxis: a difficult task in forensic medicine. Forensic Sci Int 2011;204:1–5.
2. Pumphrey RS, Roberts IS. Postmortem findings after fatal anaphylactic reactions. J Clin Pathol 2000;53:273–276.
3. DiMaio VJ, DiMaio D. In: Forensic pathology. 2nd ed. Florida: CRC Press; 2001. pp. 468-469.
4. Byard RW. An analysis of possible mechanisms of unexpected death occurring in Hydatid diease (echinococcosis). J Forensic Sci 2009;54:919–922.
5. Nara A, Aki T, Funakoshi T, et al. Death due to blood transfusion-induced anaphylactic shock: a case report. Leg Med (Tokyo) 2010;12:148–150.
6. Belton AL, Chira T. Fatal anaphylactic reaction to hair dye. Am J Forensic Med Pathol 1997;18:290–292.
7. Mayer DE, Krauskopf A, Hemmera W, et al. Usefulness of post mortem determination of serum tryptase, histamine and diamine oxidase in the diagnosis of fatal anaphylaxis. Forensic Sci Int 2011;212:96–101.
8. Edston E, van Hage-Hamsten M. beta-Tryptase measurements post-mortem in anaphylactic deaths and in controls. Forensic Sci Int 1998;93:135–142.