Hereditary alpha tryptasemia and clinical implications

Table 1 Conditions associated with high serum basal tryptase levels

Etiology	Diagnostic methods	Serum basal tryptase range	Incidence
Hereditary alpha tryptasemia	ddPCR	8-50 ng/mL	≤ 67%
No disease is detected	Exclusion diagnosis	Variable	≤ 23%
Renal failure	Glomerular filtration rate < 60 mL/minute, elevated creatinine	10-50 ng/mL	≤ 16%
Systemic mastocytosis	Bone marrow aspiration, c-KIT D816V mutation by ddPCR, skin biopsy	20-200 ng/mL	≤ 5%
Other myeloid neoplasms, acute myeloid leukemia, myeloproliferative neoplasms, myeloid neoplasms with eosinophilia, myelodysplastic neoplasms	Complete blood count, bone marrow aspiration, molecular genetics, cytogenetics	15-50 ng/mL	Rare
Hypereosinophilic syndrome	Bone marrow aspiration, molecular genetics, cytogenetics	10-50 ng/mL	Rare
Chronic inflammatory diseases, rheumatoid arthritis, eosinophilic esophagitis	Rheumatological examinations, endoscopy, biopsy	5-25 ng/mL	Rare

ddPCR: Digital droplet PCR; KIT: Tyrosine kinase protein.