Shock of unknown origin--think of mastocytosis!

Shock of unknown origin may be due to mastocytosis, in which excessive release of mast cell mediators can cause severe systemic vasodilation. We describe a patient who experienced two life-threatening episodes of shock which appeared to be due to mastocytosis. Therapeutic options are discussed.

Two thrombotic complications in a patient with active ulcerative colitis

A 30-year-old woman is described with both a cerebral venous thrombosis and a deep vein thrombosis of her leg in association with an exacerbation of her ulcerative colitis. Laboratory investigations revealed a transient functional APC resistance, without Factor V mutation, and a mild hyperhomocysteinaemia. After colectomy the APC ratio was normal. These findings may form a partial explanation of the thrombophilia seen in some patients with active ulcerative colitis.