Mast cell activation syndrome (MCAS), also commonly known as mast cell activation disease (MCAD), is an autoimmune disease in which mast cells inappropriately and excessively release chemical mediators, leading to a variety of chronic ailments, occasionally such as anaphylaxis or near-anaphylaxis strikes. Main symptoms include cardiovascular disease, dermatological, gastrointestinal, neurological and respiratory issues.
Contrary to mastocytosis, where patients have an abnormally high number of mast cells, patients using MCAS have the standard number of mast cells which don’t function correctly and are described as “hyperresponsive”. MCAS remains a poorly understood illness and is a recent subject of research.
MCAS is frequently found in patients with Ehlers–Danlos syndrome (EDS) and postural orthostatic tachycardia syndrome (POTS). It’s also found in subset groups of individuals with common variable immunodeficiency (CVID) and Lyme disease)
Symptoms and triggers
MCAS is a condition that affects multiple methods, generally within an inflammatory way. Symptoms normally wax and wane over time, varying in severity and length. Many symptoms and signs are just like those for mastocytosis, since both conditions cause too many mediators released by mast cells. It’s many overlapping features using recurrent idiopathic anaphylaxis, though there are identifying symptoms, namely hives and angioedema.
Common symptoms include:
- Dermatological
- flushing
- easy bruising
- either a reddish or a pale complexion
- itchiness
- Cardiovascular
- lightheadedness, dizziness, presyncope, syncope
- Gastrointestinal
- diarrhea, cramping, intestinal discomfort
- nausea, vomiting
- swallowing, throat tightness
- Psychological & Neurological
- brain fog, short term memory dysfunction, difficulty with recalling words
- headaches, migraines
- Respiratory
- congestion, coughing, wheezing
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- Vision/Eyes
- ocular discomfort, conjunctivitis
- Constitutional
- general fatigue and malaise
- food, drug, and chemical intolerances (especially fragrances)
- sense of being cold all the time
- Musculoskeletal
- osteoporosis and osteopenia (including young patients)
- Vision/Eyes
Causes of Mast Cell Activation Syndrome
There are no known causes, but the illness seems to be inherited from certain patients. Symptoms of MCAS are cuaes by excessive chemical mediators inappropriately released by mast cells. Mediators contain leukotrienes and histamines. The condition can be mild before exacerbated by stressful life events, or symptoms can grow and slowly tendency worse with time.
Treatment of Mast Cell Activation Syndrome
Common pharmacological treatments include:
- Mast cell stabilizers, including cromolyn sodium and natural stabilizers such as quercetin
- H1-antihistamines, such as cetirizine or ketotifen
- H2-antihistamines, such as ranitidine or famotidine
- Antileukotrienes, such as montelukast or zileuton as well as natural products (e.g., curcumin or St. John’s wort extracts)
- Nonsteroidal anti-inflammatory drugs, including aspirin can be very helpful in reducing inflammation in some patients, while others can have dangerous reactions
