Seven genes (GATA1 (adjusted P‐value = 5.57 × 10−4), TLN1 (adjusted P‐value = 9.40 × 10−4), GP1BA (adjusted P‐value = 2.15 × 10−2), SELP (adjusted P‐value = 2.29 × 10−2), MPL (adjusted P‐value = 1.20 × 10−2), F13A1 (adjusted P‐value = 1.39 × 10−2) and SPARC (adjusted P‐value = 4.06 × 10−2)) were significantly downregulated in severe anaphylaxis patients who did not receive adrenaline before ED arrival, compared with healthy controls. Here, TLN1 is linked to anaphylaxis.