{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T06:16:50Z","timestamp":1782022610400,"version":"3.54.5"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Diamine oxidase (DAO) degrades histamine, the key mediator in anaphylaxis, yet its relationship with clonal mast cell disorder (CMD) in the context of anaphylaxis is unclear. We evaluated whether DAO during anaphylaxis differs by CMD status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We enrolled 35 emergency\u2010department patients with acute anaphylaxis to drugs (7 patients), food (2 patients), or\n                      <jats:italic>Hymenoptera<\/jats:italic>\n                      venom (26 patients). Tryptase, DAO, and histamine degradation were measured during anaphylaxis and convalescence. CMD was defined by detecting\n                      <jats:italic>KIT<\/jats:italic>\n                      p.D816V in peripheral blood leukocytes using highly sensitive qPCR. Post\u2010mortem DAO and tryptase were also compared in two fatal\n                      <jats:italic>Hymenoptera<\/jats:italic>\n                      venom\u2010triggered anaphylaxis (HVA) cases with CMD versus 13 non\u2010anaphylaxis controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:italic>KIT<\/jats:italic>\n                      p.D816V was detected in 6 (17%); all had severe HVA and normal basal tryptase. During anaphylaxis, DAO increased markedly in CMD (median 1142%), but only modestly in\n                      <jats:italic>KIT<\/jats:italic>\n                      p.D816V\u2010negative patients (median 20%;\n                      <jats:italic>p\u2009&lt;<\/jats:italic>\n                      \u20090.0001), independent of trigger or severity. Acute DAO was ~5\u2010fold higher in CMD (median 101 vs. 18\u2009U\/mL), while convalescent DAO was similar (both 14\u2009U\/mL). Despite markedly elevated DAO, we observed impaired histamine degradation in acute anaphylaxis plasma. Receiver\u2010operating\u2010characteristic analyses showed strong discrimination for CMD using acute DAO (AUC 0.92; cut\u2010off 53\u2009U\/mL; sensitivity 83%; specificity 97%) and percentage increase from convalescence (AUC 0.97; cut\u2010off 223%; sensitivity 83%; specificity 100%). Post\u2010mortem DAO lacked specificity, whereas post\u2010mortem tryptase supported the diagnosis of fatal anaphylaxis and CMD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DAO concentrations rise markedly during anaphylaxis in CMD and may help identify individuals at the highest risk. Further studies should refine the diagnostic utility and elucidate the mechanisms by which DAO may amplify anaphylaxis in CMD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cea.70227","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T06:59:24Z","timestamp":1769756364000},"page":"516-525","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Markedly Increased Diamine Oxidase During Acute Anaphylaxis Is Associated With an Underlying Clonal Mast Cell Disorder"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2596-4952","authenticated-orcid":false,"given":"Matija","family":"Rijavec","sequence":"first","affiliation":[{"name":"University Clinic of Respiratory and Allergic Diseases Golnik  Golnik Slovenia"},{"name":"Biotechnical Faculty University of Ljubljana  Ljubljana Slovenia"},{"name":"Faculty of Medicine University of Maribor  Maribor 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