Immediate allergic reactions in the body are caused by mast cells. These blood cells that are part of the immune system release chemicals called mediators which, in turn, cause allergic symptoms. The condition known as mast cell activation syndrome, or MCAS, occurs when the body releases high levels of mast cells resulting in anaphylaxis or an allergic reaction that can include hives, swelling, low blood pressure, difficulty breathing, and severe diarrhea.
Mast Cells and Mast Cell Disease
Mast cells are responsible for many roles in the body, ranging from protecting from infections to allergic reactions. These immune system cells live throughout the body, including in the bone marrow, body tissues, the gastrointestinal tract, the skin, and the lining of airways.
Mast cell diseases, which include mastocytosis, mast cell activation syndrome, and hereditary alpha-tryptasemia, are quite rare. For instance, the National Institutes of Health (NIH) estimated only about 1 in 10,000 people have mastocytosis. People can be born with mast cell disease or the condition can develop during adulthood.
Symptoms of Mast Cell Disease
Because mast cells are immune system cells found throughout the body, they can impact people in a variety of ways. As a result, it is often difficult for doctors to diagnose mast cell diseases, and they can be triggered by a variety of different conditions, such as heat, cold, temperature change, friction, stress, exercise, insect and other animal bites or stings, environmental odors or perfumes, alcohol, contrast dyes, and certain foods or medicines.
Signs of mast cell disease can appear in different systems in the body and can include:
- skin: itching, flushing, hives, sweating
- eyes: itching, watering
- nose: itching, running, sneezing
- mouth and throat: itching, swelling in your tongue or lips, swelling in your throat that blocks air from getting to your lungs
- lungs: trouble breathing, wheezing
- heart and blood vessels: low blood pressure, rapid heart rate
- stomach and intestines: cramping, diarrhea, nausea, abdominal pain
- nervous system: headache, dizziness, confusion, extreme tiredness
A severe reaction can cause anaphylactic shock, in which a person may experience a rapid drop in blood pressure, a weak pulse, and narrowing of the airways. Anaphylactic shock requires emergency medical treatment.
Mast Cell Disease Diagnoses and Treatment
If someone suspects they have a mast cell disease, they should seek out an allergist or immunologist who may do blood tests, including serum tryptase, or tissue tests to determine an accurate diagnosis.
Medications that may be used in treatment include:
- H1 and H2 antihistamines
- Mast cell stabilizers (cromolyn sodium, ketotifen)
- Leukotriene inhibitors such as montelukast
- Aspirin (under direct physician’s supervision)
Aggressive mast cell diseases may require treatment with chemotherapy.
While researchers don’t yet know what exactly causes MCAS, the evidence does point to a strong genetic link. One study found 74% of those with MCAS who participated in the research had a first-degree relative with MCAS.
If you are seeking treatment for asthma or allergies, including mast cell disorder, Columbia Allergy is here to help. Our providers take a patient-focused approach that views every person as an individual with unique challenges and goals. Contact us at any of our convenient locations in California, Oregon, Idaho, and Washington to learn more about how we can help.
This is not medical advice. If you’re concerned that you may have allergies or asthma, please consult a medical professional.