Mast Cell Activation Syndrome and Mastocytosis: Initial Treatment Options and Long-Term Management. Authors: Castells M1, Butterfield J2. 1 Division of Rheumatology, Allergy, and Immunology, Brigham and Women's Hospital Mastocytosis Center, Boston, Mass. Electronic address: mcastells@bwh.harvard.edu. 2 Mayo Clinic Program for Mast Cell and Eosinophil Disorders, Mayo Clinic, Rochester, Minn. Abstract: Patients with clonal mast cell activation syndromes (MCAS) including cutaneous and systemic mastocytosis (SM) may present with symptoms of mast cell activation, but in addition can have organ damage from the local effects of tissue infiltration by clonal mast cells. Patients with nonclonal MCAS may have chronic or episodic mast cell activation symptoms with an increase in serum tryptase and/or urinary metabolites of histamine, prostaglandin D2, and leukotrienes. Symptoms of MCAS and SM can be managed by blockade of mediator receptors (H1 and H2 antihistamines, leukotriene r...
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