Know the symptoms of mast cell activation syndrome and how they can affect your health.

Mastocitary activation syndrome (SACM) is a complex disorder characterized by the abnormal release of mastocity substances in response to various triggers. The mast cells, a type of white blood cells found in the tissues of the entire organism, play a crucial role in the responses of our immune system. However, in people with MCAS, these mastiffs are hyperactive and release excessive amounts of histamine and other inflammatory substances, which causes a wide range of symptoms.

Although MCAS symptoms may vary from one person to another, some common signs can help identify the disease. One of the distinctive features of SACM is the presence of recurring episodes of blush and cutaneous itch. This is usually accompanied by gastrointestinal symptoms such as abdominal pain, swelling, diarrhea or constipation. In addition, people with MCAS may experience respiratory symptoms such as difficulty breathing, wheezing or nasal congestion.

Important information:

• Mastocyte activation syndrome (SACM) is characterized by abnormal release of mastocity substances.
• The most frequent symptoms are blush, skin on the skin, abdominal pain and respiratory symptoms.

In addition, MCAS can affect other organism systems, such as cardiovascular, musculoskeletal and nervous. Cardiovascular symptoms may include tachycardia, hypotension or even fainting. Musculoskeletic symptoms can manifest as joint pain, muscle pains and even bone pain. In addition, people with SACM can experience neurological symptoms such as brain fog, migraines and dizziness.

Mast Cell Activation Syndrome Symptoms

Common symptoms of mast cell activation syndrome include:

• Rubor and generalized heat on the skin
• Urticaria or eruptions with itching
• Swelling, especially in the face and limbs
• Abdominal pain, cramps and diarrhea
• Headaches and migraines
• Fatigue and weakness
• Cerebral mist and difficulty concentrating
• Pain and joint stiffness

In addition to these common symptoms, people with MCAS can also experience less common symptoms, such as palpitations, difficulty breathing, low blood pressure and even anaphylaxis. It is important to keep in mind that SACM symptoms can vary greatly from one person to another and that can also imitate the symptoms of other diseases, which hinders diagnosis.

It is essential that people who experience persistent and inexplicable symptoms consult with a healthcare professional who knows mastocity disorders well. A complete medical history, a specific physical examination and laboratory tests can help confirm the diagnosis of mast cell activation syndrome.

Understanding Mast Cells

Mast cells

• Mastocies derive from bone marrow progenitor cells and mature in different tissues
• They are densely granulated and contain numerous secretory vesicles full of bioactive molecules
• Their surface is decorated with a high density of cell receptors, which allows them to recognize and respond to various stimuli
• Mastocies intervene mainly in allergic reactions, wound healing and parasites defense.

Table & GT; symptoms of mast cell activation syndrome

Mastocyte activation syndrome (SACM) is a disease characterized by an abnormal and excessive release of mediators by mast cells, which results in a wide range of symptoms that can affect multiple organic systems. It can be triggered by various factors, such as physical effort, stress, medications or certain foods. SACM symptoms can vary greatly from one person to another, so their diagnosis and treatment constitute a challenge.

Common Symptoms of Mast Cell Activation Syndrome

1. Ski n-related symptoms: One of the most prevalent clinical characteristics of SACM affects the skin. Patients usually experience symptoms such as blush, hives, angioedema (swelling) and pruritus. These symptoms may appear spontaneously or as a consequence of triggers such as temperature changes, physical pressure or exposure to certain foods or chemicals.

• Flushing: This symptom refers to sudden redness and warming of the skin, typically on the face and upper body. It is caused by the dilation of blood vessels due to the activation of mast cells.
• Hives: SMAC can cause hives, which are raised, itchy red welts on the skin. These hives can appear anywhere on the body and can vary in size and shape.
• Angioedema: In some cases, SMCA can cause swelling of the deeper layers of the skin and mucous membranes. This swelling is usually characterized by a sudden onset and can affect the lips, eyelids, hands, feet or genital area.
• Pruritus: Pruritus is a common symptom associated with the activation of mast cells in the SMAC. The itching may be localized or generalized and may worsen with scratching or rubbing.

2. 2. Gastrointestinal symptoms: Another set of symptoms frequently seen in SMCA affects the gastrointestinal (GI) system. Patients may experience abdominal pain, bloating, diarrhea, constipation, nausea and vomiting. These gastrointestinal symptoms usually appear after exposure to triggers such as certain foods, stress or medications.

1. Abdominal pain: Abdominal pain related to MCAS can range from mild discomfort to severe cramping. The pain is usually described as cramping and may be associated with bloating or abdominal distension.
2. Abdominal distension: Many individuals with MCAS experience a feeling of abdominal fullness and bloating, even after consuming small amounts of food.
3. Diarrhea and constipation: Fluctuations in bowel habits are common in MCAS. Some patients may have frequent loose stools or diarrhea, while others may experience constipation or difficulty defecating.
4. Nausea and vomiting: MCAS can trigger episodes of nausea and vomiting, which may be accompanied by abdominal pain or discomfort.

“It is important to note that while these symptoms are commonly associated with MCAS, they can also occur in other medical conditions. Therefore, a thorough evaluation by a healthcare professional is crucial for accurate diagnosis and appropriate treatment.”

Physical Symptoms of Mast Cell Activation Syndrome

Gastrointestinal symptoms:

• Abdominal pain
• Nausea and vomiting
• Diarrhea or constipation
• Abdominal distension and gas
• Heartburn

Dermatological symptoms:

• Urticaria
• Flushing or redness of the skin
• Pruritus or itching
• Angioedema (skin swelling)
• Blisters or skin injuries

Important: It is essential to keep in mind that these symptoms may not always be present or vary from one person to another. Some people with MCAS may experience a combination of gastrointestinal, dermatological and other symptoms, while others can only show symptoms in specific body systems. In addition, the severity and frequency of symptoms can also fluctuate, with triggers such as stress or certain foods that exacerbate the response of mast cells.

Respiratory symptoms:

• Short of breath
• Sibilations
• Cough
• Thoracic oppression
• Difficulty breathing

Cardiovascular symptoms:

• Palpitations or tachycardia
• Low blood pressure or hypotension
• Dizziness or vertigo
• Irregular heart rate
• Fluctuations of heart rate or blood pressure

Important: These respiratory and cardiovascular symptoms can be especially worrisome and require immediate medical care. If you experience severe respiratory distress, chest pain or fainting, it is important that you look for emergency medical attention.

Psychological Symptoms of Mast Cell Activation Syndrome

People with MCAS may experience various psychological symptoms, such as anxiety, depression, humor changes and cognitive dysfunction. These symptoms can be very weakening and exacerbate the physical manifestations of the SQAM. It is important that health professionals recognize and address the psychological component of the SMAA to provide comprehensive care to patients.

Anxiety: Many people with SACM experience an increase in anxiety due to constant uncertainty and fear associated with the unpredictable nature of the disease. The physical discomfort caused by the activation of mast cells can also contribute to the feelings of anxiety and panic.

Depression: The chronic nature of SACM, along with the limitations imposed on daily activities, can cause feelings of sadness and depression. The constant fight against symptoms and the impact on social relations can contribute to a feeling of hopelessness and despair.

Humor changes: fluctuations in mast cells can affect the neurotransmitters of the brain, causing changes in mood and emotional instability. People with MCAS may experience rapid changes between feelings of joy and despair, which hinders the maintenance of emotional balance.

It is essential that healthcare professionals take into account the psychological symptoms of SMAC in their therapeutic approach. Addressing these symptoms along with the physical manifestations of the disease can help improve the overall well-being and quality of life of people living with SMCA.

Diagnosing Mast Cell Activation Syndrome

During the initial evaluation, healthcare professionals typically ask about the patient’s medical history, focusing on any allergic reactions, chronic symptoms such as fatigue or gastrointestinal problems, and triggers that may exacerbate symptoms. They will then do a physical examination to check for common signs of MCAS, such as redness or swelling of the skin, enlarged lymph nodes, and abnormal heart sounds.

• Medical history: Ask about allergies, chronic symptoms and triggers.
• Physical examination: Check for skin redness, swelling, enlarged lymph nodes, and abnormal heart sounds.
• Laboratory Tests: Measure serum tryptase levels and perform additional tests based on symptoms.
• Tryptase test: Increased levels suggest activation of mast cells.

Note: Diagnosis of MCAS involves a thorough evaluation of the medical history, physical examination, and specific laboratory tests.

A crucial laboratory test for the diagnosis of SACM is the measurement of serum tryptase levels. Tryptase is an enzyme released by activated mast cells, and increased levels suggest mast cell activation. Although this test can be informative, it is important to keep in mind that normal tryptase levels do not exclude the possibility of SACM. Therefore, healthcare professionals may also perform additional laboratory tests based on the patient’s specific symptoms, such as blood or urine tests to evaluate inflammatory markers or chemical mediators.

1. Treatment history: Evaluate responses to previous treatments.
2. Elimination diet: Identify possible triggers using a trial elimination diet.
3. Provocation testing: Observe reactions to specific triggers in a controlled medical setting.

In addition to the medical history, physical examination and laboratory tests, health professionals can also take into account patient treatment history. The evaluation of the individual’s previous therapeutic responses can provide valuable information about the possibility of MCAS. In addition, an elimination diet can be used as a tool to identify possible triggers through the systematic elimination and reintroduction of specific foods or substances. Another diagnostic approach is the provocation tests, in which the patient is exposed to known triggers in a controlled medical environment to observe any reaction that may occur.

In summary, the diagnosis of mast cell activation syndrome implies an exhaustive evaluation of the individual’s medical history, a specific physical examination and laboratory tests. The process may also include the evaluation of the history of treatment, the realization of elimination diets and the conduct of provocation tests. A multidimensional approach is necessary to reach a precise diagnosis and differentiate the SACM from other conditions with similar symptoms.

Treatment Options for Managing Mast Cell Activation Syndrome Symptoms

1. 1. Medication: Pharmacological interventions play a crucial role in the treatment of SACM symptoms. Antihistamines, such as cetirizine and Lorateradine, can help block the effects of histamine released by mast cells, reducing symptoms such as itching, hives and nasal congestion. In addition, stabilizer medications, such as sodium chromoglycate and ketifen, can help prevent mast cells from giving and release inflammatory mediators. These medications can be taken orally or in the form of nostrils to treat specific symptoms.

IMPORTANT: It is essential to collaborate closely with a wel l-informed healthcare professional to determine the most appropriate medication guideline to treat MCAS symptoms. The dose and the combination of medications can vary for each person depending on their specific symptoms and their general health status.

2. Dietary modifications: Many people with SACM find relief to their symptoms making specific changes in the diet. Avoiding triggers, such as certain foods, food additives and preservatives, can help reduce mast cells and minimize allergic reactions. Taking a food diary and working with a dietitian titled with experience in the treatment of SMAA can be beneficial to identify and eliminate possible triggers. A low histamine diet, low in food such as cured cheese, fermented foods and processed meats, can also help relieve symptoms.

3. Modifications of lifestyle: Making certain modifications in lifestyle can also contribute to effectively control MCAS symptoms. Stress reduction techniques, such as meditation, deep breathing exercises and yoga, can help regulate the immune system and reduce mast cells. Creating a quiet and free environment of allergens at home, using hypoallergenic bedding and avoiding exposure to strong chemicals or odors, can also be beneficial. It is important to listen to the body and avoid activities or environments that trigger allergic reactions or worsen symptoms.

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Author of the article

Dr.Greenblatt M.

Medical oncologist at the Robert Larner College of Medicine, MD, at the University of Vermont