Treatment should be initiated in the presence of clinical suspicion and hemodynamic compromise, as anaphylaxis is truly a clinical diagnosis. Blood tests have no role in the acute diagnosis of severe allergy and anaphylaxis. However, certain acute biomarkers are helpful, retrospectively, in cases where the diagnosis may not be clear, or to assist in guiding the allergist consultant in future therapeutic management. In severe allergic reactions, elevations in tryptase, histamine, and platelet-activating factor (a vasoactive mediator) were noted in 61%, 75%, and nearly 100% of patients, respectively, in a study by Vadas et al.61
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