IGHE and allergic disease: The reasons for excluding patients with high-acuity illness are likely due to the difficulty differentiating some of the severe infection symptoms from severe IgE-mediated symptoms and moreover infections reduce the threshold of developing anaphylactic reactions and so a patient with acute infection also suffering an anaphylactic reaction may result in death when they may have otherwise survived the episode of care.37 However, the risk of allergy in patients selected for DDPT is low and comparable to that for the general population.