ENPP3 and anaphylaxis: In piecemeal degranulation, small vesicles from the histamine-containing granules are formed and rapidly shuttled to the plasma membrane.[30,31] This process could lead to the upregulation of CD203c, present in other small vesicles distinct from histamine-containing granules,[33] and may be linked to stimulation by certain drugs and the development of severe reactions like anaphylactic shock.[18] In the second mechanism, anaphylactic degranulation, the main granules are fused to the plasma membrane, releasing the entire contents to the extracellular space.