EPISODE · Mar 24, 2026 · 1H 4M
Ep. 266 Clinical Steps for Efficient Anaphylaxis Diagnosis & Treatment with Dr. Payel Gupta
from BackTable ENT · host BackTable
Anaphylaxis doesn’t always look like hives and swelling. In up to 20% of cases, the skin is completely clear, making the diagnosis easy to miss. On this episode of the BackTable ENT & Allergy Podcast, Dr. Basil Kahwash speaks with Dr. Payel Gupta, allergist and immunologist at Mount Sinai in New York City, about how to recognize and manage anaphylaxis. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:02 - Defining Anaphylaxis and Key Signs04:09 - Anaphylaxis Versus Shock05:54 - Diagnostic Pitfalls12:43 - Epi First Epi Fast32:33 - ER Or Observe42:31 - Allergy Testing Limits47:16 - New Anaphylaxis Therapies51:34 - Public Awareness and Advocacy01:02:55 - Final Pearls and Wrap up --- More about this episode Dr. Gupta and Dr. Kahwash first define anaphylaxis and review common diagnostic pitfalls, including absent skin findings, overlap with asthma, atypical presentations, delayed reactions, and the effects of beta-blockers. Dr. Gupta emphasizes the importance of early treatment with intramuscular epinephrine. Antihistamines and steroids are discussed as adjunctive therapies and the episode reviews the risk and management of biphasic reactions. The conversation also covers optimal timing for tryptase testing, post-reaction counseling, evolving guidance on emergency department referral, and appropriate timing for allergy testing after a reaction. Dr. Gupta discusses emerging options such as intranasal epinephrine and the use of omalizumab to increase reaction thresholds in food allergy. The episode concludes with a discussion of public misconceptions around the term “allergy,” barriers to appropriate care, and Dr. Gupta’s advocacy and educational work. --- Resources Dr. Payel Gupta https://www.zocdoc.com/doctor/payel-gupta-md-facaai-571583
What this episode covers
Anaphylaxis doesn’t always look like hives and swelling. In up to 20% of cases, the skin is completely clear, making the diagnosis easy to miss. On this episode of the BackTable ENT & Allergy Podcast, Dr. Basil Kahwash speaks with Dr. Payel Gupta, allergist and immunologist at Mount Sinai in New York City, about how to recognize and manage anaphylaxis. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:02 - Defining Anaphylaxis and Key Signs04:09 - Anaphylaxis Versus Shock05:54 - Diagnostic Pitfalls12:43 - Epi First Epi Fast32:33 - ER Or Observe42:31 - Allergy Testing Limits47:16 - New Anaphylaxis Therapies51:34 - Public Awareness and Advocacy01:02:55 - Final Pearls and Wrap up --- More about this episode Dr. Gupta and Dr. Kahwash first define anaphylaxis and review common diagnostic pitfalls, including absent skin findings, overlap with asthma, atypical presentations, delayed reactions, and the effects of beta-blockers. Dr. Gupta emphasizes the importance of early treatment with intramuscular epinephrine. Antihistamines and steroids are discussed as adjunctive therapies and the episode reviews the risk and management of biphasic reactions. The conversation also covers optimal timing for tryptase testing, post-reaction counseling, evolving guidance on emergency department referral, and appropriate timing for allergy testing after a reaction. Dr. Gupta discusses emerging options such as intranasal epinephrine and the use of omalizumab to increase reaction thresholds in food allergy. The episode concludes with a discussion of public misconceptions around the term “allergy,” barriers to appropriate care, and Dr. Gupta’s advocacy and educational work. --- Resources Dr. Payel Gupta https://www.zocdoc.com/doctor/payel-gupta-md-facaai-571583
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Ep. 266 Clinical Steps for Efficient Anaphylaxis Diagnosis & Treatment with Dr. Payel Gupta
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