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Dr. Andrew Rynne

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A friend of mine had surgery on her foot ..4

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Dr. Kaushal Bhavsar

Pulmonologist

Practicing since :2008

Answered : 14180 Questions

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Posted on Fri, 18 Jan 2019 in Asthma and Allergy
Question: A friend of mine had surgery on her foot ..4 days later she broke out in a severe case of hives.. after a couple of steroid shots and antihistamines the hives finally settled down.. she was advised to see an allergist..2 weeks later she went to the allergist where she was examined and still showed signs of activity in her eyes.. slightly swollen .. the doctor gave her a tryptase blood test and it was 16 .. thinking it was a fluke she repeated the test the next day it was 15.5..the next visit she had a allergic skin test which came up clean with the exception of a few seasonal allergies.. she had been taking an allergy pill everyday but had stopped taking it before the surgery.. the surgery was a minor foot surgery.. she was given the diagnosis of mastocytosis that day in the office..can other things cause a rise in tryptase.. she has had inflammation of the colon due to diviticulitis but she has never had hives before this last breakout.. could she have this rare disease.. is it dangerous.. will it shorten her life? Should she have other test? Thanks so much!!
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Follow up: Dr. Kaushal Bhavsar 0 minute later
A friend of mine had surgery on her foot ..4 days later she broke out in a severe case of hives.. after a couple of steroid shots and antihistamines the hives finally settled down.. she was advised to see an allergist..2 weeks later she went to the allergist where she was examined and still showed signs of activity in her eyes.. slightly swollen .. the doctor gave her a tryptase blood test and it was 16 .. thinking it was a fluke she repeated the test the next day it was 15.5..the next visit she had a allergic skin test which came up clean with the exception of a few seasonal allergies.. she had been taking an allergy pill everyday but had stopped taking it before the surgery.. the surgery was a minor foot surgery.. she was given the diagnosis of mastocytosis that day in the office..can other things cause a rise in tryptase.. she has had inflammation of the colon due to diviticulitis but she has never had hives before this last breakout.. could she have this rare disease.. is it dangerous.. will it shorten her life? Should she have other test? Thanks so much!!
doctor
Answered by Dr. Kaushal Bhavsar 1 hour later
Brief Answer:
Anaphylaxis and mastocytosis can cause elevated tryptase levels.

Detailed Answer:
Thanks for your question on Ask a doctor forum.
I can understand your concern.
Tryptase is an enzyme secreted by mast cells and mast cells are raised in allergic reactions like anaphylaxis.
Since she was having anaphylaxis reaction (severe hives), mast cells are raised which is reflected by raised tryptase levels.
In my opinion, she should get done repeat test after 2-3 months.
This is not at all life threatening condition.
So no need to worry for life shortening.
She should definitely get done absolute eosinophil count, serum IgE levels to confirm that this is allergic only.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your friend. Thanks.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Kaushal Bhavsar 0 minute later
Brief Answer:
Anaphylaxis and mastocytosis can cause elevated tryptase levels.

Detailed Answer:
Thanks for your question on Ask a doctor forum.
I can understand your concern.
Tryptase is an enzyme secreted by mast cells and mast cells are raised in allergic reactions like anaphylaxis.
Since she was having anaphylaxis reaction (severe hives), mast cells are raised which is reflected by raised tryptase levels.
In my opinion, she should get done repeat test after 2-3 months.
This is not at all life threatening condition.
So no need to worry for life shortening.
She should definitely get done absolute eosinophil count, serum IgE levels to confirm that this is allergic only.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your friend. Thanks.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Kaushal Bhavsar 4 hours later
Can the tryptase levels stay elevated for 3 weeks after a severe hives breakout.. can a spider bite cause it to elevate? Thanks so much!!
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Follow up: Dr. Kaushal Bhavsar 0 minute later
Can the tryptase levels stay elevated for 3 weeks after a severe hives breakout.. can a spider bite cause it to elevate? Thanks so much!!
doctor
Answered by Dr. Kaushal Bhavsar 1 hour later
Brief Answer:
Yes, spider bite can cause elevated tryptase.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
Yes, spider bite can cause raised tryptase levels.
But this is not with all the spiders. Some spider bite can cause anaphylaxis.
And levels start reducing after 2 weeks.
So it is advisable to get done repeat test after 1-2 months of treatment.
Is he has history of spider bite?
I will be happy to help you further. Wishing good health to your friend. Thanks.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Kaushal Bhavsar 0 minute later
Brief Answer:
Yes, spider bite can cause elevated tryptase.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
Yes, spider bite can cause raised tryptase levels.
But this is not with all the spiders. Some spider bite can cause anaphylaxis.
And levels start reducing after 2 weeks.
So it is advisable to get done repeat test after 1-2 months of treatment.
Is he has history of spider bite?
I will be happy to help you further. Wishing good health to your friend. Thanks.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Kaushal Bhavsar 14 hours later
No she does not have a history of spider bites but the morning after she had a very flushed face we found a spider crawling on her wall .. she did not break out in hives until 4 days later..the first symptom was a very flushed face..it looked like she had a high fever..just looking for any connections to what could have caused the high tryptase levels ..I will have her do the other tests mentioned.. what about a bone marrow biopsy.. will she need that?? Thank you so much for your very caring detailed answers! I appreciate you so much!!❤️
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Follow up: Dr. Kaushal Bhavsar 0 minute later
No she does not have a history of spider bites but the morning after she had a very flushed face we found a spider crawling on her wall .. she did not break out in hives until 4 days later..the first symptom was a very flushed face..it looked like she had a high fever..just looking for any connections to what could have caused the high tryptase levels ..I will have her do the other tests mentioned.. what about a bone marrow biopsy.. will she need that?? Thank you so much for your very caring detailed answers! I appreciate you so much!!❤️
doctor
Answered by Dr. Kaushal Bhavsar 3 minutes later
Brief Answer:
I don't think spider bite has caused this.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
Honestly speaking, I don't think spider bite has caused this.
At present there seems no role of bone marrow biopsy.
But do let me know
1. Does she have weight loss or anorexia or low grade fever?
2. Is she anemic?
3. Does she have abdominal pain or backache?
4. Has she undergone ultrasound examination of abdomen?
Do reply me answers of above asked questions so that I can guide about bone marrow biopsy.
I will be happy to help you further. Wishing good health to your friend. Thanks.
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
doctor
Answered by Dr. Kaushal Bhavsar 0 minute later
Brief Answer:
I don't think spider bite has caused this.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
Honestly speaking, I don't think spider bite has caused this.
At present there seems no role of bone marrow biopsy.
But do let me know
1. Does she have weight loss or anorexia or low grade fever?
2. Is she anemic?
3. Does she have abdominal pain or backache?
4. Has she undergone ultrasound examination of abdomen?
Do reply me answers of above asked questions so that I can guide about bone marrow biopsy.
I will be happy to help you further. Wishing good health to your friend. Thanks.
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Kaushal Bhavsar 1 hour later
No weight loss ..I think she has gained a few pounds lately.. she had blood work not too long ago and I believe it was all within normal range..I do not believe she is anemic..no new symptoms expect she has had lots of indigestion lately.. she had never had indigestion before..so she has been eating the tums to relieve it.. she has been taking a lot of ibuprofen lately for foot pain..and she does have that history of inflammation of the intestinal area..sometimes food will go right through her so she must watch what she eats.. thanks for all your advice!!
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Follow up: Dr. Kaushal Bhavsar 0 minute later
No weight loss ..I think she has gained a few pounds lately.. she had blood work not too long ago and I believe it was all within normal range..I do not believe she is anemic..no new symptoms expect she has had lots of indigestion lately.. she had never had indigestion before..so she has been eating the tums to relieve it.. she has been taking a lot of ibuprofen lately for foot pain..and she does have that history of inflammation of the intestinal area..sometimes food will go right through her so she must watch what she eats.. thanks for all your advice!!
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Follow up: Dr. Kaushal Bhavsar 3 minutes later
Not sure of low grade fever...she had hives so bad that they thought she had scabies ..they misdiagnosed her but she was given the meds for it and she took the potent meds because she was hurting so bad..
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Follow up: Dr. Kaushal Bhavsar 0 minute later
Not sure of low grade fever...she had hives so bad that they thought she had scabies ..they misdiagnosed her but she was given the meds for it and she took the potent meds because she was hurting so bad..
doctor
Answered by Dr. Kaushal Bhavsar 17 minutes later
Brief Answer:
No need for bone marrow biopsy.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
By your answers, I don't think she needs bone marrow biopsy.
Since she is having intestinal symptoms more, better to get done ultrasound or CT scan of abdomen.
Has she done either of them?
And do let me know when she gets absolute eosinophil count and serum IgE done.
I will be happy to help you further. Wishing good health to your friend. Thanks.
I forgot to ask one important thing. Is she taking any anti allergic medicine?
If not she needs to take.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Kaushal Bhavsar 0 minute later
Brief Answer:
No need for bone marrow biopsy.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
By your answers, I don't think she needs bone marrow biopsy.
Since she is having intestinal symptoms more, better to get done ultrasound or CT scan of abdomen.
Has she done either of them?
And do let me know when she gets absolute eosinophil count and serum IgE done.
I will be happy to help you further. Wishing good health to your friend. Thanks.
I forgot to ask one important thing. Is she taking any anti allergic medicine?
If not she needs to take.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Kaushal Bhavsar 38 hours later
She is taking anti allergic meds..I will let her know about getting ultrasound on her abdomen.. you are a wonderful caring doctor thanks so much.. I will keep you posted!! I appreciate you!!
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Follow up: Dr. Kaushal Bhavsar 0 minute later
She is taking anti allergic meds..I will let her know about getting ultrasound on her abdomen.. you are a wonderful caring doctor thanks so much.. I will keep you posted!! I appreciate you!!
doctor
Answered by Dr. Kaushal Bhavsar 37 minutes later
Brief Answer:
Thanks for your kind words.

Detailed Answer:
Thanks for your follow up question.
Appreciate the kind words.

Do let me know her progress.
I will be happy to help you further.

Wishing your friend a good health
Thanks.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Answered by Dr. Kaushal Bhavsar 0 minute later
Brief Answer:
Thanks for your kind words.

Detailed Answer:
Thanks for your follow up question.
Appreciate the kind words.

Do let me know her progress.
I will be happy to help you further.

Wishing your friend a good health
Thanks.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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