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February 2, 2026Clinical & Experimental AllergyOpen Access

Markedly Increased Diamine Oxidase During Acute Anaphylaxis Is Associated With an Underlying Clonal Mast Cell Disorder

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Authors

MRM. RijavecŽKŽan KogovšekJIJezerka Inkret

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Overview

Evaluates DAO levels during anaphylaxis in patients with clonal mast cell disorder, implying potential diagnostic utility.

Key Points

  • The aim is to assess the relationship between diamine oxidase levels and clonal mast cell disorder during acute anaphylaxis.
  • Enrolled 35 patients with acute anaphylaxis from emergency department.
  • Measured DAO, tryptase, and histamine levels during anaphylaxis and recovery phases.
  • Analyzed KIT p.D816V mutations in peripheral blood leukocytes using qPCR.
  • Compared post-mortem DAO and tryptase levels between fatal anaphylaxis cases and controls.
  • Conducted receiver-operating-characteristic analyses for DAO levels regarding CMD status.
  • KIT p.D816V was found in 17% of patients, all with severe anaphylaxis and normal tryptase.
  • DAO levels increased significantly in CMD patients (median 1142%) compared to 20% in non-CMD patients (p < 0.0001).
  • Acute DAO was approximately 5-fold higher in CMD patients (median 101 U/mL) than in non-CMD patients (18 U/mL).
  • Strong discrimination for CMD status was noted with acute DAO and its increase from convalescence, with high sensitivity and specificity.
  • Post-mortem DAO had low specificity, but tryptase levels supported diagnosis of fatal anaphylaxis.

Cite This Study

Rijavec et al. (2026) studied this question.

synapsesocial.com/papers/6980feeac1c9540dea8117b7https://doi.org/10.1111/cea.70227
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