Proposed diagnostic algorithm for patients with suspected mast cell activation syndrome

Valent, Peter and Akin, Cem and Bonadonna, Patrizia and Hartmann, Karin and Brockow, Knut and Niedoszytko, Marek and Nedoszytko, Boguslaw and Siebenhaar, Frank and Sperr, Wolfgang R. and Oude Elberink, Joanna N. G. and Butterfield, Joseph H. and Alvarez-Twose, Ivan and Sotlar, Karl and Reiter, Andreas and Kluin-Nelemans, Hanneke C. and Hermine, Olivier and Gotlib, Jason and Broesby-Olsen, Sigurd and Orfao, Alberto and Horny, Hans-Peter and Triggiani, Massimo and Arock, Michel and Schwartz, Lawrence B. and Metcalfe, Dean D.. (2019) Proposed diagnostic algorithm for patients with suspected mast cell activation syndrome. The Journal of Allergy and Clinical Immunology: In Practice, 7 (4). pp. 1125-1133.e1.

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Official URL: https://edoc.unibas.ch/70715/

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Mast cell activation (MCA) accompanies diverse physiologic and pathologic processes and is one of the more frequently encountered conditions in medicine. MCA-related symptoms are usually mild and often transient. In such cases, histamine receptor blockers and other mediator-targeting drugs can usually control MCA. In severe cases, an MCA syndrome (MCAS) may be diagnosed. However, overt MCAS is an unusual condition, and many patients referred because of suspected MCAS are diagnosed with other diseases (autoimmune, neoplastic, or infectious) unrelated to MCA or suffer from MCA-related (eg, allergic) disorders and/or comorbidities without fulfilling criteria of an overt MCAS. These considerations are important as more and more patients are informed that they may have MCA or even MCAS without completing a thorough medical evaluation. In fact, in several instances, symptoms are misinterpreted as MCA/MCAS, and other clinically relevant conditions are not thoroughly pursued. The number of such referrals is increasing. To avoid such unnecessary referrals and to prevent misdiagnoses, we here propose a diagnostic algorithm through which a clinically relevant (systemic) MCA can be suspected and MCAS can subsequently be documented or excluded. In addition, the algorithm proposed should help guide the investigating care providers to consider the 2 principal diagnoses that may underlie MCAS, namely, severe allergy and systemic mastocytosis accompanied by severe MCA. Although validation is required, we anticipate that this algorithm will facilitate the management of patients with suspected MCAS.
Faculties and Departments:03 Faculty of Medicine > Departement Biomedizin > Department of Biomedicine, University Hospital Basel > Allergy and Immunity (Hartmann)
UniBasel Contributors:Hartmann, Karin
Item Type:Article, refereed
Article Subtype:Research Article
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:10 Nov 2020 16:36
Deposited On:10 Nov 2020 16:36

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