Should KIT D816V be checked in all patients with a stinging insect allergy, even with a normal tryptase, so that mastocytosis is not missed in patients with a normal tryptase?

Perhaps not in all patients but certainly in those with hypotensive, syncopal, or presyncopal symptoms regardless of tryptase levels, as well as in those with tryptase levels above 8 ng/ml.

Most patients with Hymenoptera venom allergy (HVA) do not have systemic mastocytosis (SM). Therefore, I would not recommend KIT p.D816V testing of blood for every patient with HVA. The Spanish mastocytosis group developed a useful SM screening test score largely based on symptoms that occur during a...

No

In my practice, I check all patients with a systemic Hymenoptera stinging insect allergy for the peripheral blood KIT D816V mutation in conjunction with a baseline serum tryptase. If there is a high clinical suspicion, I will also proceed with a bone marrow biopsy even in the presence of a normal tr...