Original ArticlesPostmortem Tryptase Level in 120 Consecutive Nonanaphylactic Deaths Establishing a Reference Range as <23 μg/LGarland, Jack BMed∗; Philcox, Winston BHSc†; McCarthy, Sinead DTM&H‡; Mathew, Suneeth PhD, MBChB‡; Hensby-Bennett, Sarah BSc(Hons), MBChB§; Ondrushka, Benjamin MD∥; Woydt, Lina MD¶; Da Broi, Ugo MD, PhD#; Palmiere, Cristian MD∗∗; Lam, Leo MBChB††; Ahn, Yeri MBChB‡‡; Olds, Kelly BHSc§§; Glenn, Charley MD‡; Morrow, Paul MD, MPH‡; Kesha, Kilak MD‡; Stables, Simon MNZM, MB, ChB, DAvMed, AsFACAsM, FNZSP, FRCPA3‡; Tse, Rexson BSc, MB, BS, FRCPA†,‡Author Information From the ∗Forensic and Analytical Science Service, NSW Health Pathology, New South Wales, Australia †School of Medicine, Faculty of Medical and Health Sciences, University of Auckland ‡Department of Forensic Pathology, LabPLUS, Auckland City Hospital, Auckland, New Zealand §Waikato District Health Board, Hamilton, New Zealand ∥Institute of Legal Medicine, University of Leipzig, Leipzig ¶Institute of Legal Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Germany #Department of Medicine, Section of Forensic Medicine, University of Udine, Udine, Italy ∗∗CURML, University Center of Legal Medicine, Lausanne University Hospital, Lausanne, Switzerland Departments of ††Biochemistry ‡‡Immunopathology, LabPLUS, Auckland City Hospital, Auckland, New Zealand §§School of Medicine, University of Notre Dame, Fremantle, Western Australia, Australia. Manuscript received July 1, 2019; accepted August 21, 2019. The authors received no funding for this work. Reprints: Rexson Tse, BSc, MB, BS, FRCPA, Department of Forensic Pathology, LabPLUS, Auckland City Hospital, Auckland 1148, New Zealand. E-mail: [email protected]; [email protected]. The authors report no conflict of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.amjforensicmedicine.com). The American Journal of Forensic Medicine and Pathology: December 2019 - Volume 40 - Issue 4 - p 351-355 doi: 10.1097/PAF.0000000000000515 Buy SDC Metrics Abstract Postmortem tryptase is a useful biochemical test to aid the diagnosis of anaphylaxis. Multiple perimortem and postmortem factors have been documented to cause an elevation in postmortem tryptase level. One factor that was recently recognized to have an impact on postmortem tryptase level is correct sampling technique. A recent study recommended aspirating blood samples from a clamped femoral/external iliac vein to be used for reliable postmortem tryptase analysis. This study sampled 120 consecutive nonanaphylactic deaths in which all the peripheral bloods were sampled as recommended. Postmortem interval, resuscitation, different nonanaphylactic causes of death, sex, and age did not show any statistical significant relation to postmortem tryptase level in Student t test, Pearson correlation, and univariate and multivariate analyses. The mean (SD) postmortem tryptase level was 8.4 (5.2) μg/L (minimum, 1.0 μg/L; maximum, 36.1 μg/L; median, 7.3 μg/L). Using nonparametric methods, the postmortem tryptase reference range in nonanaphylactic death was established as <23 μg/L (97.5th percentile). Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.