Mast Cell Activation Disorder

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MCAS awareness ribbon 

Mast Cell Activation Syndrome (MCAS) is a type of Mast Cell Activation Disorder (MCAD). MCAS is an immunological disorder where Mast cells are inappropriately and excessively released (hyperresponsive). There is some speculation that mast cells can be altered as part of a connective tissue disorder such as EDS. There is also a relationship between Mast Cells and Dysautonomia. One study of patients with EDS and POTS found 66% had symptoms consistent with MCAS

 

Mast cells are part of the immune system that detects and responds to foreign substances. Once activated these cells explode to release chemicals called mediators. Mast Cells start in the bone marrow and are found throughout the entire body. 

MCAS can cause a range of symptoms including cardiovascular, dermatological, gastrointestinal, neurological and respiratory problems In some cases anaphylaxis or near anaphylaxis can occur which can be life-threatening. These symptoms can be triggered by a large variety of things including (but not limited to) food, temperature, medications, exercise, emotional/physical stress, scents/smells, bug bites, skin friction/pressure etc. 

Some of the symptoms can include:

  • Dermatological

Flushing

Hives

Easy bruising

Dermatographism

Itchiness

Burning

Flushing

  • Cardiovascular

Dizziness

Presyncope

Syncope

Tachycardia​

  • Gastrointestinal

Diarrhoea

Constipation

Cramping/Intestinal Discomfort ​

  • Respiratory

Wheezing

Coughing​

Shortness of Breath

  • Anaphylaxis 

  • Neurological 

Headache​

Brain Fog

Cognitive Dysfunction

Anxiety/Depression

  • Urinary and Gynecological Issues

Diagnosis is done through a 24hr urine collection, blood test and clinical symptoms. Lab test for MCAS are not always positive if the person is not having an attack. There is also limited testing in Australia without consistent test procedures. 

Treatment is usually through avoiding triggers and taking medications (such as H1 and H2 antihistamines, sodium cromoglicate, ketotifen, omlalizumab etc.)

References: https://www.ehlers-danlos.com/2017-eds-classification-non-experts/mast-cell-disorders-ehlers-danlos-syndrome-2/