Presentation
Results of laboratory testing including mast cell mediator levels, and clinical symptoms on presentation and during follow-up were analyzed. [ncbi.nlm.nih.gov]
Entire Body System
- Pathologist
A templated format, excellent color photographs, authoritative content, and online access make this an ideal reference for busy pathologists. [euro-libris.ro]
The pathologist was then informed of the clinical diagnosis. A Giemsa stain confirmed the diagnosis of mastocytosis. The presumptive diagnosis at the time of hospital discharge was cutaneous mastocytosis. [aafp.org]
The sample(s) are then analyzed by a pathologist. A common site for a bone marrow biopsy and aspiration is the pelvic bone, which is located in the lower back by the hip. [mastocytosisaustralasia.com]
Editor-in-Chief, Journal of Cutaneous Pathology Timothy McCalmont, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, American Society of Dermatopathology, California Medical Association, College of American Pathologists [emedicine.medscape.com]
Respiratoric
- Aspiration
The bone marrow aspirate showed a dense mast cell infiltrate confirming systemic involvement. [ncbi.nlm.nih.gov]
Minor Mast cells in bone marrow, or other extracutaneous organs show abnormal (spindling) morphology (>25%) or the presence of greater than 25% atypical mast cells in bone marrow aspirates Demonstration of c- kit point mutation on codon 816 in bone marrow [epathologies.com]
An aspiration removes a sample of fluid with a needle. The sample(s) are then analyzed by a pathologist. A common site for a bone marrow biopsy and aspiration is the pelvic bone, which is located in the lower back by the hip. [mastocytosisaustralasia.com]
Bone marrow aspirations were not conducted during the evaluation. After NICU discharge, the patient was visited to the emergency center, and then re-admitted twice at 1 month and 2 months of age because of unfounded crying and irritability. [synapse.koreamed.org]
Mast cells in biopsy sections or aspirate smears in mastocytosis have an aberrant morphology including spindle shapes, cytoplasmic projections, hypogranulation, and oval, eccentric nucleus sometimes with bilobulation (22). 2. [worldallergy.org]
Gastrointestinal
- Vomiting
"It causes hives, blisters, flushing, stomach pain, nausea, vomiting," said Ewell. The condition is extremely very rare and enlarged the spleen and liver, yet Ewell said both function normally. [waff.com]
When she was discharged the vomiting episodes continued -- every three weeks like clockwork. After a year of doctors' visits, Ali was finally diagnosed with cyclic vomiting syndrome. [cnn.com]
Clinical features include: cutaneous manifestations flushing hypotension and syncope abdominal pain nausea, vomiting and diarrhea malabsorption bone pain and pathological fractures associated hematological disorders 7 Mast cells are bone marrow-derived [radiopaedia.org]
Symptoms such as nausea, vomiting, and diarrhea may also be present with urticaria pigmentosa. Solitary mastocytoma. [mastocytosisaustralasia.com]
A person with this type of mastocytosis may also experience nausea, vomiting, and diarrhea. Solitary mastocytoma. This type of mastocytosis is more common in infants and children than in adults. [cancer.net]
- Nausea
"It causes hives, blisters, flushing, stomach pain, nausea, vomiting," said Ewell. The condition is extremely very rare and enlarged the spleen and liver, yet Ewell said both function normally. [waff.com]
Clinical features include: cutaneous manifestations flushing hypotension and syncope abdominal pain nausea, vomiting and diarrhea malabsorption bone pain and pathological fractures associated hematological disorders 7 Mast cells are bone marrow-derived [radiopaedia.org]
Symptoms such as nausea, vomiting, and diarrhea may also be present with urticaria pigmentosa. Solitary mastocytoma. [mastocytosisaustralasia.com]
A person with this type of mastocytosis may also experience nausea, vomiting, and diarrhea. Solitary mastocytoma. This type of mastocytosis is more common in infants and children than in adults. [cancer.net]
COMMON SIGNS & SYMPTOMS Itching/hives/rash/flushing Anaphylaxis Abdominal cramping/discomfort/pain Skin lesions Low blood pressure/fainting/dizziness/fatigue Bone/muscle pain Nausea/vomiting/migraines Other Signs & Symptoms Hematological abnormalities [knowcancer.com]
Liver, Gall & Pancreas
- Hepatomegaly
Systemic symptoms (including flushing, hypotension, severe anaphylaxis, hepatomegaly, diarrhea and gastrointestinal bleeding) appear to be more common in DCM than in other forms of CM with systemic symptoms. [mastowyattwarrior.org]
Systemic involvement as bones (osteolytic lesions), hepatomegaly, splenomegaly, gastrointestinal involvement with diarrhea and cardiovascular involvement with flushing, tachycardia, and shock are often associated. [ijpd.in]
Hepatomegaly (27%), splenomegaly (37%), and lymphadenopathy (21%) can be found in adult patients with systemic mastocytosis. [epathologies.com]
Hepatomegaly and splenomegaly. Cardiovascular: Syncope, hypotension or anaphylactic shock. Haematological and bones: Anaemia or other cytopenias (if bone marrow involvement). Hypersplenism. Lymphadenopathy. Fractures (if bone marrow involved). [patient.info]
[…] manifestations; urticaria, pruritus, dermatographia mediator-related; abdominal pain, flushing, syncope, hypertension or hypotension, headache, tachycardia, respiratory symptoms bone-related; pain, fractures, arthralgia splenomegaly, less often lymphadenopathy, hepatomegaly [e-immunohistochemistry.info]
Cardiovascular
- Palpitations
These include flushing, headache, palpitations, abdominal pain, diarrhoea, dyspnoea, wheezing, syncope, hypotensive shock and death. Early onset of blisters worsens the prognosis. [patient.info]
[…] eruptiva perstans: Small lesions that do not itch Systemic mastocytosis: Skin lesions Urticaria pigmentosa Facial flushing Itching Nausea Vomiting Diarrhea Abdominal pain Ulcers in the stomach and duodenum (small intestine) Headache Lightheadedness Heart palpitations [mastocytosisaustralasia.com]
[…] mastocytosis. 5 The prevalence of systemic involvement increases with age, and approaches 15 to 30 percent in adults with skin lesions. 10, 11 Patients with systemic disease frequently report intermittent, brief spells of urticaria, flushing, pruritus, palpitations [aafp.org]
Frequently these patients have a number of recurrent symptoms, which include: flushing of the face, neck, and upper chest; episodes of dizziness or syncope oftern associated with mild to severe hypotension; chest pain, palpitations, and dyspnea; and nausea [sdominko.tripod.com]
Skin
- Blister
Bullous mastocytosis (diffuse cutaneous mastocytosis) is a rare form of mast cell disease that begins during the first month of life and causes extensive blisters that mimic scalded skin syndrome or bullous erythema multiforme. [ncbi.nlm.nih.gov]
'My baby looks like a burns victim': Boy suffers from extremely rare condition which leaves his body covered in painful blisters Geraint Burns, 18 months old, has diffuse cutaneous mastocytosis His skin is so fragile it blisters agonisingly at the slightest [dailymail.co.uk]
"He was born covered head to toe with hives, blisters, nodules, and doctors had no idea what was wrong with him," she said. Doctors everywhere were looking for a diagnosis. [waff.com]
- Papule
Discrete pigmented macules, papules, and nodules are absent and the characteristic leathery induration of skin may not develop until 6 months of age. Skin biopsy shows a subepidermal blister with mast cells at the base. [ncbi.nlm.nih.gov]
Within the thickened skin are tiny, yellowish papules that impart their color to the skin. [clinicaladvisor.com]
History The original description of mastocytosis was given by Nettleship and Tay on a 2 yr old girl with hyper pigmented papules that spontaneously urticated in 1869 Later in 1877, Paul Ehrlich discovered the mast cell Unna was the first to demonstrate [slideshare.net]
Most common form of mastocytosis, characterized by multiple persistant small reddish brown hyperpigmented pruritic macules and papules. [icd10data.com]
This should be considered if patients develop any systemic symptoms Generalized eruption of cutaneous mastocytosis (adult type) is the most common pattern of mastocytosis presenting to the dermatologist, with the most common lesions being macules, papules [en.wikipedia.org]
- Hyperpigmentation
Piebaldism 105 108 Tinea versicolor 107 109 Lichen sclerosis 109 111 Morphea 111 112 Nevus depigmentosus 112 114 Hypomelanosis of Ito 114 116 Mongolian spots 116 118 Caféaulait macules CALMs 118 120 Junctional nevi 120 122 Lentigines 122 124 Postinflammatory hyperpigmentation [books.google.com]
[…] vesiculation Bullous mastocytosis may be diagnosed by Tzank smear; infiltrate may be slight and perivascular In telangiectasia macularis eruptive perstans, features may be subtle, with increased mast cells around dilated superficial capillaries, basal cell hyperpigmentation [pathologyoutlines.com]
In addition, hyperpigmentation of lesions may occur due to the melanocyte-stimulating effects of mast cell growth factor, 9 and it is interesting to note that our case had increased skin pigmentation. [synapse.koreamed.org]
[…] eruptiva perstans A rare form of mastocytosis seen < 1% of cases Age: usually appears in the adults Lesion: patients develop crops of numerous itchy, ill defined, telangiectatic, brown macules, 3-8mm in size Longstanding lesions develop hyperpigmentation [slideshare.net]
The induction of melanocytes explains the hyperpigmentation that commonly is associated with cutaneous mast cell lesions. [emedicine.medscape.com]
- Macula
The authors report the case of a male infant who developed maculae and maculopapulae on his legs and abdomen when aged 3.5 months, which spread to all body surfaces within weeks. [ncbi.nlm.nih.gov]
In adults the lesion s are disseminated and tend to be red or brown and macula r or maculopapular. 2. Diffuse cutaneous mastocytosis: Occurs almost exclusively in childhood. The skin is diffuse ly thickened and may have an orange peel appearance. [seer.cancer.gov]
Workup
Infectious workup was negative and shave biopsy revealed a dense, diffuse dermal infiltrate of mast cells, consistent with diffuse cutaneous bullous mastocytosis-a rare variant of cutaneous mastocytosis. [ncbi.nlm.nih.gov]
Mast cell activation disease: a concise practical guide for diagnostic workup and therapeutic options. J Hematol Oncol, 4(10), 10.1186/1756-8722-4-10 [ii] Hartmann K, et al. (2016). [mastattack.org]
A bone scan, GI workup, and identification of the D816V c-kit mutation can also be helpful in cases where the diagnosis requires confirmation. [merckmanuals.com]
The pattern of aeroallergen and food sensitization and asthma in atopic patients with mastocytosis did not differ from that found in patients without mastocytosis but a comprehensive allergic workup (including skin prick testing, total and specific IgE [worldallergy.org]
Ultrasound
- Enlargement of the Liver
They are: blood tests – including a full blood count (FBC) and measuring blood tryptase levels an ultrasound scan to look for enlargement of the liver and spleen if it seems likely a DEXA scan to measure bone density a bone marrow biopsy test – where [nhs.uk]
Serum
- Thrombocytosis
[…] associated hematological non-mast cell lineage disease (SM-AHNMD) Code Also, if applicable, any associated hematological non-mast cell lineage disease, such as: acute myeloid leukemia ( C92.6-, C92.A- ) chronic myelomonocytic leukemia ( C93.1- ) essential thrombocytosis [icd10data.com]
[…] abdominal pain, flushing, syncope, hypertension or hypotension, headache, tachycardia, respiratory symptoms bone-related; pain, fractures, arthralgia splenomegaly, less often lymphadenopathy, hepatomegaly haematological; anaemia, leukocytosis or leukopenia, thrombocytosis [e-immunohistochemistry.info]
Splenomegaly is seen in 50-60% of the patients Lymph node enlargement is seen in patients with advanced systemic disease Hematological abnormalities like mild normochromic normocytic anemia, leukocytosis or leukopenia, eosinophilia, monocytosis, and thrombocytosis [slideshare.net]
Familial urticaria pigmentosa associated with thrombocytosis as the initial symptom of systemic mastocytosis and Down's syndrome. J Eur Acad Dermatol Venereol. 2003 Nov. 17(6):718-22. [Medline]. Soilleux EJ, Brown VL, Bowling J. [emedicine.medscape.com]
Treatment
Treatment was started with oral dimethindine maleate. At the age of 18 months, oral sodium cromoglicate (SCG) was introduced. At the age of 23 months, additional treatment was started with a cutaneous emulsion containing 4% SCG. [ncbi.nlm.nih.gov]
[…] of advanced mastocytosis; Treatment strategies of mediator related symptoms in mastocytosis; and Neuro and psychological involvement in Mastocytosis. [books.google.com]
Prognosis
Although our results suggest generally favourable prognosis, the review of the literature indicate that SM may occur. Therefore, more guarded prognosis should be given in DCM patients. [ncbi.nlm.nih.gov]
In SM-AHNMD, the prognosis depends on the course of the associated haematological disorder. Agressive systemic mastocytosis and mast cell leukaemia have a poorer prognosis. [patient.info]
Articles in this issue include Human Mast Cell Signal Transduction; Mast cell tryptase role in homeostasis and coagulation; Mastocytosis: Current Classification and Diagnostic criteria; Epidemiology, risk factors and prognosis of mastocytosis; Mast cell [books.google.com]
Etiology
Etiology in many patients involves an activating mutation (D816V) in the gene coding for the stem cell factor receptor c-kit, which is present on mast cells. [merckmanuals.com]
Etiology The etiology of mastocytosis remains unknown. Children who develop this disease usually have a self-limited disorder, whih often resolves before adulthood. [sdominko.tripod.com]
Etiology Mastocytosis probably is a hyperplastic response to an abnormal stimulus. [emedicine.medscape.com]
Epidemiology
Articles in this issue include Human Mast Cell Signal Transduction; Mast cell tryptase role in homeostasis and coagulation; Mastocytosis: Current Classification and Diagnostic criteria; Epidemiology, risk factors and prognosis of mastocytosis; Mast cell [books.google.com]
Mastocytosis (cutaneous and systemic): Epidemiology, pathogenesis, and clinical manifestations. UpToDate. December 5, 2016; http://www.uptodate.com/contents/mastocytosis-cutaneous-and-systemic-epidemiology-pathogenesis-and-clinical-manifestations. [rarediseases.info.nih.gov]
A mutation of the oncogene C-KIT D816V is found in many (but not all) cases. [ 9 ] Epidemiology [ 10 ] This is a rare and heterogeneous group of disorders, of which urticaria pigmentosa is the most common manifestation. [patient.info]
Epidemiology cutaneous mastocytosis (CM): accounts for 80% of cases of mastocytosis. It most commonly seen in children, 80% of whom are less than 6 months old. [e-immunohistochemistry.info]
Epidemiology: Mastocytosis is seen in all ethnic backgrounds. Estimated incidence is approximately 1:20,000 (4). It occurs in males and females in approximately equal ratios. [worldallergy.org]
Pathophysiology
Pathophysiology Mastocytosis is now classified with the myeloproliferative neoplasms. [5] Increased local concentrations of soluble mast cell growth factor in lesions of cutaneous mastocytosis are believed to stimulate mast cell proliferation, melanocyte [emedicine.medscape.com]
In addition to the age of onset, adult and pediatric forms of mastocytosis differ in their clinical course and pathophysiology. [sdominko.tripod.com]
Pathophysiology Mast cells originate from bone marrow progenitor cells and are distributed throughout the connective tissues. They are concentrated in the skin around the peripheral nerves and adjacent to blood and lymphatic vessels. [aafp.org]
Prevention
A comprehensive diagnostic approach, advanced therapeutic strategies, regular follow-ups, and instruction of patients and relatives on prevention and prophylaxis are highly indicated. [ncbi.nlm.nih.gov]
Your skin Holds body fluids in, preventing dehydration Keeps harmful microbes out, preventing infections Helps you feel things like heat, cold, and pain Keeps your body temperature even Makes vitamin D when the sun shines on it Anything that irritates [icdlist.com]
Mast cell stabilizers help prevent mast cells from releasing their chemical contents. Cromoglicic acid is the only medicine specifically approved by the FDA for the treatment of mastocytosis. [en.wikipedia.org]
Follow-up physical examinations and skin evaluations are important in the early diagnosis and prevention of this condition. [mastocytosisaustralasia.com]
PREVENTION The following “triggers” may influence a mast cell response: drug abuse, excessive alcoho consumption, preservatives, stress, sunlight, environmental toxins, bacteria/fungi/mold, artificial colors or flavorings, heat/cold, etc. [knowcancer.com]