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![Figure 3.](/view/journals/anpr/70/2/inline-i1878-7177-70-2-93-f03.png)
Changes in Blood Concentrations of Histamine and Tryptase After the Onset of Anaphylaxis
When anaphylaxis occurs, mast cells and basophils release histamine and tryptase. To diagnose anaphylaxis, blood samples should be collected at 2 times: the onset of anaphylaxis and after 24 hours. Histamine and tryptase levels should be compared.
![Figure 2.](/view/journals/anpr/70/2/inline-i1878-7177-70-2-93-f02.png)
Management of Anaphylaxis in the Dental Office
Anaphylaxis should be recognized at an early stage, epinephrine should be administered intramuscularly, and the patient should be transported immediately to a hospital.
*Implement steps 3–5 promptly and simultaneously. 1
![Figure 1.](/view/journals/anpr/70/2/inline-i1878-7177-70-2-93-f01.png)
Skin Involvement and Anaphylaxis
(a) Skin findings developed after the oral administration of antibiotics and analgesics following the extraction of a third molar. (b) Skin findings on the face and ears immediately developed after the induction of general anesthesia. Lower left figure: At the onset of anaphylactic shock. Lower right figure: After treatment of anaphylactic shock.
![Figure.](/view/journals/anpr/67/3/inline-i0003-3006-67-3-172-f01.png)
Basophil activation test (BAT) results. Activated basophil counts for the negative control (2.8%), positive control (35.2%), flomoxef (2.2%), rocuronium (3.2%), and rubber dam sheet (54.7%) challenges. Stimulation of naïve basophils with the rubber dam sheet elicited a strong positive result (1-hour contact; sample concentration, 1/1250). Evaluation criteria for activated basophils were as follows: <6% negative, 6–10% false-positive, 10–15% weakly positive, 15–20% positive, and >20% strongly positive.