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Once the sheen of oil is no longer visible, the next step is sensory testing in which trained observers test gathered or cooked seafood for the smell of oil

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d) Evaluating clonal mast cell disorders CMCD, such as monoclonal mast cell activation syndrome (MMAS) and systemic mastocytosis (SM), may present with recurrent IA, or severe hymenoptera sting anaphylaxis, especially if characterized by hypotension and absence of skin symptoms [3, 19, 37, 4649]