Mastocytosis and Anaphylaxis — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardGeneral Internal MedicineMastocytosis and AnaphylaxisRACP Adult Medicine

A 40-year-old woman with systemic mastocytosis develops anaphylaxis during a hymenoptera (wasp) sting. She recovers with adrenaline. What is the long-term management to prevent recurrence?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Venom immunotherapy (VIT) – potentially lifelong

Patients with systemic mastocytosis and hymenoptera venom anaphylaxis should receive venom immunotherapy (VIT), which dramatically reduces the risk of recurrent systemic reactions. Unlike in the general population where VIT can be ceased after 3–5 years, patients with mastocytosis may require LIFELONG VIT due to the persistent risk. An adrenaline autoinjector should also be carried at all times. Baseline serum tryptase >11.4 µg/L predicts more severe anaphylaxis.

Reference: ASCIA – 2024 – Anaphylaxis Guidelines; EAACI – 2022 – Venom Allergy Guidelines