A 42-year-old woman on chronic opioid therapy for cancer pain develops acute chest pain, dyspnea, and hypotension 30 minutes after receiving a bolus of intravenous morphine. Cardiac auscultation reveals no new murmurs. Which investigation is most specific for diagnosing opioid-induced anaphylactoid reaction (non-IgE-mediated mast cell degranulation)?

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