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Mast Cell Disorder

Mast cells are resident cells located in most body tissue including the skin, conjunctiva of the eyes, mucosa of the lungs and digestive system, liver, spleen, bone marrow, and brain.  These cells normally play an important role in the immune system protecting the body from infection, but also are involved in allergic disease, urticaria, and anaphylaxis.

When excess mast cells infiltrate body tissue, mast cell disorders such as mastocytosis result. 

Mastocytosis is classified as cutaneous (skin) or systemic, and occurs in both children and adults.  The most common form of cutaneous mastocytosis is urticaria pigmentosa and primarily involves the skin.  In contrast, systemic mastocytosis primarily involves mast cell infiltration of extra-cutaneous organs such as the bone marrow, liver or spleen.

Mast cells contain inflammatory mediators including histamine, prostaglandins, leukotrienes, and tryptase among others. 

As mast cell mediators are released in cases of systemic mastocytosis, a constellation of signs and symptoms may develop including:

  • Itching
  • Flushing
  • Rash
  • Headache
  • Lightheadedness
  • Depression
  • Abdominal Discomfort
  • Nausea and Vomiting
  • Ulcers
  • Diarrhea
  • Anaphylaxis
  • Musculoskeletal Pain
  • Decreased Bone Density

Triggers for mast cell mediator release include:

  • Narcotics
  • NSAIDS
  • Contrast Dye
  • Physical factors [heat, humidity, cold, lack of sleep]
  • Alcohol
  • Infection
  • Stress
  • Insect Sting

Allergists are experts in mast cell disorders and diagnose these conditions by history, exam, and tests which may include skin biopsy, blood and urine assays, as well as bone marrow evaluation.

The goals in the treatment of mast cell disorders are the prevention of adverse symptoms associated with mediator release.

Treatment options are focused on mitigating the adverse effects of mast cell mediators and commonly include antihistamines, antacids, leukotriene receptor antagonists, and epinephrine auto-injectors for the treatment of possible anaphylaxis.

By visiting an Allergist, you too can take control of your mast cell disorder and improve your quality of life.

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