IGHE and anaphylaxis: As indicated in various publications the patient was at a very high risk of developing anaphylaxis because he was a male suffering from systemic indolent mastocytosis, with previous anaphylactic episodes involving hypotension and syncope, with baseline serum tryptase > 20  ng/mL and baseline serum total IgE compatible with immunological sensitization and an absence of urticaria pigmentosa [22, 35, 41].