The problem of anaphylaxis and mastocytosis.
Mastocytosis is a rare disease characterized by an elevated whole body mast cell number. Anaphylaxis is a severe, generalized hypersensitivity reaction with rapid onset. The problem of anaphylaxis and mastocytosis is due to strongly increased mediator release from the elevated mast cell number during allergic reactions. This explains the much higher prevalence of anaphylaxis in mastocytosis than in the general population and its severe and sometimes fatal course. Because of the increased risk of anaphylaxis in mastocytosis, all patients with severe or recurrent anaphylaxis should be analyzed for underlying mastocytosis by estimation of baseline serum tryptase. If this is elevated, patients also should be tested via skin examination for cutaneous mastocytosis and with a bone marrow biopsy. All patients with mastocytosis and anaphylaxis must be instructed about avoiding the responsible elicitors and should carry an emergency kit with adrenaline for self-application. In mastocytosis patients with anaphylaxis due to Hymenoptera stings, venom immunotherapy is recommended for life.
Müller
Ulrich R
UR
Allergy Division, Department of Medicine, Spital Ziegler, Spitalnetzbern, Bern, Switzerland. ulrich.mueller@spitalnetzbern.ch
Haeberli
Gabrielle
G
D000707:Anaphylaxis / Q000209:etiology* / Q000276:immunology / Q000517:prevention & control*; D000818:Animals; D018926:Anti-Allergic Agents / Q000627:therapeutic use; D001180:Arthropod Venoms / Q000276:immunology; D006801:Humans; D006927:Hymenoptera / Q000276:immunology; D008407:Mast Cells / Q000276:immunology; D008415:Mastocytosis / Q000150:complications* / Q000188:drug therapy / Q000276:immunology*; D053802:Tryptases / Q000097:blood / Q000276:immunology
D018926:Anti-Allergic Agents; D001180:Arthropod Venoms; D053802:Tryptases