1st order laboratory parameters – obligatory laboratory tests.
- Blood gas analysis (ABG) – for circulatory instability/shock; determination of:
- Venous: pH, BE. (Lactate) [Lactate ↑ = oxygen deficiency due to inhibition of aerobic glycolysis]
Laboratory parameters 2nd order – depending on the results of the history, physical examination and the obligatory laboratory parameters – for differential diagnostic clarification.
- IgE, total allergen-specific IgE, anti-IgA.
- Tryptase (mast cell tryptase) – in suspected anaphylactic shock [values 20-200 μg/l; decrease to normal within 24-48 hours].
- Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment, if necessary urine culture (pathogen detection and resistogram, that is, testing of suitable antibiotics for sensitivity/resistance).
- Electrolytes – calcium, chloride, potassium, magnesium, sodium, phosphate.
- Fasting glucose (fasting blood glucose).
- Blood culture or blood cultures (without delay) – if septic shock is suspected.
- Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT), alkaline phosphatase, bilirubin.
- Renal parameters – urea, creatinine, cystatin C or creatinine clearance, if necessary.
- Coagulation parameters – PTT, Quick
- Toxicological tests – for suspected intoxications.
- Thyroid parameters – TSH
Further notes
- Meat allergy diagnostics: if alpha-Gal-mediated meat allergy is suspected, test for total extract (beef, pork, and lamb) and allergen component (alpha-Gal). Galactose-alpha-1-3-galactose (alpha-Gal) is a disaccharide that occurs in the meat of beef, pork, lamb and game (muscle meat and offal) or their cells.Occurrence of an anaphylactic reaction about 4 to 6 hours after contact with the allergen.It is assumed that sensitization to alpha-Gal occurs primarily via ticks; a tick bite in the history thus supports the diagnosis of alpha-gal syndrome.
