Andrew A Dahl, MD, FACS Assistant Professor of Surgery (Ophthalmology), New York College of Medicine (NYCOM); Director of Residency Ophthalmology Training, The Institute for Family Health and Mid-Hudson Family Practice Residency Program; Staff Ophthalmologist, Telluride Medical Center
Andrew A Dahl, MD, FACS is a member of the following medical societies: American Academy of Ophthalmology , American College of Surgeons , American Intraocular Lens Society, American Medical Association , American Society of Cataract and Refractive Surgery , Contact Lens Association of Ophthalmologists , Medical Society of the State of New York , New York State Ophthalmological Society , Outpatient Ophthalmic Surgery Society
Disclosure: Nothing to disclose.
Probably the major cause of high histamine is recently discovered Heriditary Alpha Typtasemia which 6% of the population has, inheriting extra copies of the alpha tryptase gene, and links three diseases. POTS, Ehler Danlos, and MCAS (Mast Cell Activation Disorder). One study actually shows tryptase keeps you from going into anaphylactic shock. Patients who suspect they may have hereditary alpha tryptasemia syndrome should first have a baseline blood tryptase test drawn by their doctor, if they haven’t already. It should not be drawn immediately after a major allergic reaction, as that can lead to an elevated tryptase for a different reason. A serum level greater than 10 ng/ml is suggestive of alpha tryptasemia, while a level lower than 8ng/ml makes this diagnosis far less likely. There is no commercially available test for the genetic duplication, and it cannot be identified through usual genetic testing including microarrays, whole exome sequencing, or whole genome sequencing. The research-based test that can diagnose alpha tryptasemia is under development.
1. Josephson JE, Zantos S, Caffery BE, et al. Differentiation of corneal complications observed in contact lens wearers. J Am Optom Assoc. 1988 Sep;59(9):679-85.
2. Catania L. Primary Care of the Anterior Segment. Connecticut: Appleton & Lange; 1995.
3. Krachmer JH, Mannis MJ, Holland EJ. Cornea. St. Louis, Mo.: Mosby/Elsevier; 2011.
4. Efron N. Sterile Keratitis. In: Contact Lens Complications. Oxford: Butterworth-Heinemann; 2004:168-70.
5. Levin LA, Adler FH. Adler’s physiology of the eye. Edinburgh: Saunders/Elsevier; 2011.
6. Behrens A, Doyle JJ, Stern L, et al. Dysfunctional tear syndrome: a Delphi approach to treatment recommendations. Cornea. 2006 Sep;25(8):900-7.
7. Kanski JJ. Clinical ophthalmology: A Systematic Approach. Edinburgh: Butterworth-Heinemann; 2011.
8. Garner A, Klintworth G. Pathobiology of Ocular Disease. England: Informa Healthcare; April 19, 1994.
9. Robbins SL, Kumar V. Basic Pathology. Philadelphia: Saunders; 2007.
10. Bartlett JD, Jaanus SD. Clinical Ocular Pharmacology. Oxford: Butterworth-Heinemann; 2008.