Tryptase Stain Results Finally Here

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DebE13
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Tryptase Stain Results Finally Here

Post by DebE13 »

My labs work finally came back and reads as follows:

Per your written request and retrospective to case sign-out, an immunostain for mast cell tryptase was performed on specimen "D" and "E" (terminal ileum and whole colon, respectively) with results interpreted below:

D. Biopsy in the terminal ileum- there are up to 10 mast cells/hpf on the tryptase stain sections

E. Biopsy in the whole colon- mast cell tryptase stain negative for increased mast cells.

My GI has yet to contact me about the results and I had to make a special request for my lab reports so I could see the information. Would this be because there are no findings that need to be addressed? I am the one who insisted on the stain. I don't know where I fall within the expected ranges for normal or if I need to address anything further with my diet. I have for years now had increased histamine type issues but am not sure if it is allergy related or food related.

I interpretations are welcome.
Deb

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tex
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Post by tex »

Hi Deb,

Up to 10 mast cells per high power field is within the normal range, so you don't have mastocytic enterocolitis. A diagnosis of ME requires 20 or more mast cells per hpf. In between 10 and 20 is an undefined area.

That finding doesn't rule out mast cell activation disorder (MCAD) of course, but MCAD (if it exists) can only be diagnosed within a few hours of the triggering of an actual mast cell event.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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DebE13
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Post by DebE13 »

Thanks Tex, so how does it get dx when one wouldn't be eating anything to trigger it because of the colonoscopy prep? Or can it be triggered in non-food related ways?
Deb

"Do not follow where the path may lead. Go instead, where there is no path, and leave a trail.
-Ralph Waldo Emerson

2007 CC
2013 thyroid cancer- total thyroidectomy
2013 Hashimoto's - numbers always "normal"
2017 Lyme's Disease
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tex
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Post by tex »

Hi Deb,

The blood test for tryptase has nothing to do with biopsy samples. It's done on a blood sample drawn during a mast cell event.

Here's some info on it. The timing of the draw is critical for valid results.
Normally, the level of tryptase in the blood is very low. When mast cells are activated, the level increases rapidly, rising within 15 to 30 minutes, peaking at 1 to 2 hours, and returning to normal after several hours to a couple of days. In people with severe allergies, activation of many mast cells can cause an extreme form of allergic reaction known as anaphylaxis, which can cause low blood pressure, hives (blisters on the skin), severe narrowing of the air passages, and even death. Tryptase levels will be very high in people with anaphylaxis.

In some cases, tryptase levels will be high in persons with mast cell activation disorders, in which mast cells become activated without apparent allergies or other reasons.

Tryptase Blood Test

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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DebE13
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Post by DebE13 »

Oops, now I'm confused. :oops:

Was it worth asking for the tryptase stain from the colonoscopy? I thought I had a basic understanding of it but maybe not?
Deb

"Do not follow where the path may lead. Go instead, where there is no path, and leave a trail.
-Ralph Waldo Emerson

2007 CC
2013 thyroid cancer- total thyroidectomy
2013 Hashimoto's - numbers always "normal"
2017 Lyme's Disease
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tex
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Post by tex »

Deb wrote:Was it worth asking for the tryptase stain from the colonoscopy?
Sure, because that ruled out mastocytic enterocolitis.

ME is a result of excess numbers of mast cells. MCAD is a result of overactive mast cells, despite a normal mast cell count. In order to treat a mast cell problem (if it exists), one must know what type of mast cell problem is causing the symptoms.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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