Venom anaphylaxis can mimic other serious conditions and disclose important underlying disease

Systemic allergic reactions to venoms are common and there is a known association between venom anaphylaxis (VA) and systemic mastocytosis (SM).1 SM is diagnosed (or ruled out) by a bone marrow (BM) examination, but this procedure is considered unfeasible in the large number of patients with venom allergy and complete absence of other signs or symptoms indicative of mastocytosis. Current recommendations suggest the use of baseline serum tryptase to screen for underlying SM in patients with VA.2 However, a substantial fraction of patients with SM have a normal baseline tryptase level, and a diagnosis of mastocytosis could be overlooked using only this screening approach, with potentially severe implications.

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