Management of mastocytosis

Delayed diagnosis of adult indolent systemic mastocytosis

Systemic mastocytosis (SM) is a rare, heterogeneous disorder characterized by infiltration and accumulation of mast cells within multiple organs, most commonly the skin. Given the rarity of the disease and the fact that many of its symptoms are shared by more common disorders, a diagnosis may be delayed or hindered. These patients have an elevated risk of developing potentially life-threatening anaphylactoid reactions, thus underscoring the importance of keeping SM in mind as a differential diagnosis when a patient presents with chronic, itchy skin lesions and a history of multiple allergic reactions to bites, drugs, and anesthesia. We present a case illustrating that features of SM common to many disorders may hinder or delay its diagnosis.

Mastocytosis

Mastocytosis is characterized by pathologic accumulation and activation of mast cells in tissues and organs. Although the classification for mastocytosis and diagnostic criteria are well accepted, there remains a need to define standards for the application of diagnostic tests, clinical evaluations, and responses to treatment. The objective of this article was to make an extensive literature review, providing comprehensive knowledge about the etiopathological and pathophysiological mechanisms, with a special emphasis on diagnosis, classification and treatment of mastocytosis, promoting continued medical education.

Case report of mastocytosis in an adult

A case of adult-onset mastocytosis is presented to illustrate the classification, signs, symptoms, workup, treatment, and prognosis for this unusual condition. Although there is no cure for mastocytosis, symptoms of histamine release can be minimized with oral antihistamines. Ongoing surveillance of organ systems affected remains important. Our patient's mast cell disease predisposed him to bone loss, but there was no evidence of disease beyond the skin. He has done well with continued follow up monitoring his serum tryptase and oral antihistamine treatment.

Systemic Mastocytosis: Clinical Manifestations and Differential Diagnosis

Mast cells produce symptoms by local and remote effects of mediator release and by their presence in increased numbers in normal tissue and bone marrow, where they damage and impair normal organ function. Moreover, mast cells are long-lived and heterogeneous in their response to secretagogues and to inhibitors of mediator release. Clinicians sorting out the diagnosis of SM on the basis of presenting signs and symptoms continue to have their diagnostic skills challenged because of the rarity of this disorder, the fact that many symptoms of SM are present in more common disorders, and the multiple guises that SM may assume at the time of presentation.

Therapeutic approach to selected neonatal eruptions

Management of numerous neonatal eruptions has been modified over the past 10 years. In this article, traditional and developing therapeutic insights are applied to both common and uncommon neonatal conditions.