Drug hypersensitivity reactions and allergy in patients with mastocytosis

Czarny, Justyna; Lange, Magdalena; Niedoszytko, Marek; Kwiecińska, Barbara; Górska, Aleksandra; Ługowska-Umer, Hanna; Sikorska, Monika; Nowicki, Roman

doi:10.5114/dr.2017.66219

Cited by 3 publications

(2 citation statements)

References 30 publications

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“…Nevertheless, mastocytosis patients require prophylactic antimediator therapy (PAT) and adequate anesthetic management. The PAT is based on H1/H2 antihistamines, glucocorticoids and benzodiazepines given 1 h before the anesthesia [33, 38]. It is suggested to avoid morphine and codeine [39, 40], thiopental [40], succinylcholine [40], mivacurium [40, 41], atracurium [40, 41], rocuronium [40], nefopam [41].…”

Section: Prevention Of the Anaphylaxismentioning

confidence: 99%

Cutaneous mastocytosis treatment: strategies, limitations and perspectives

Czarny¹,

Lange²,

Ługowska-Umer³

et al. 2018

pdia

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Mastocytosis is a rare myeloproliferative disease, characterized by excessive proliferation and accumulation of mast cells in the tissues. In cutaneous mastocytosis (CM), mast cells infiltration is limited to the skin, whereas in systemic mastocytosis (SM) internal organs are involved. The first-line treatment in CM is antimediator therapy (mainly H1 and H2 antihistamines) and short-term topical corticosteroids. Phototherapy is the second-line therapy which may be considered when antihistamines do not produce the expected improvement. New therapeutic options include omalizumab and KIT-targeting agents. Although the disappearance of skin lesions has been reported as a result of cytoreductive therapies in SM, the use of potentially toxic drugs in CM is not recommended. In all adults with mastocytosis and in pediatric patients with severe CM, a persistently elevated serum tryptase level and anaphylaxis in medical history, equipping with epinephrine autoinjector for use in case of anaphylaxis is recommended.

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Section: Prevention Of the Anaphylaxismentioning

confidence: 99%

Cutaneous mastocytosis treatment: strategies, limitations and perspectives

Czarny¹,

Lange²,

Ługowska-Umer³

et al. 2018

pdia

Self Cite

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“…However, this approach might lead to deprivation of proper perioperative analgesia or even needed surgical treatment for SM patients. Furthermore, some authors suggested that severe pain that is not relieved with proper opioid treatment might also cause MC activation [61,62]. Carter et al reported that the risk of anaphylaxis may be significantly greater in major surgeries, patients with anaphylaxis history and in patients not receiving anti-mediator therapy including histamine receptor (HR)1-targeting and HR2-targeting drug [53].…”

Section: General Anestheticsmentioning

confidence: 99%

A Challenge for Allergologist: Application of Allergy Diagnostic Methods in Mast Cell Disorders

Romantowski

Górska

Niedoszytko

et al. 2021

IJMS

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Primary and secondary mast cell activation syndromes (MCAS) can occur in patients with mastocytosis. During the past few years our knowledge about the pathogenesis and disease-triggering mechanisms in MCAS and mastocytosis have increased substantially. Whereas mastocytosis is characterized by an accumulation of neoplastic (clonal) mast cells (MC) in various organ systems, MCAS is defined by a massive and systemic activation of these cells. Mast cells are crucial effector cells in allergic diseases, thus their elevated number and activation can cause severe anaphylactic reactions and MCAS in patients with mastocytosis. However, these cells may also degranulate spontaneously or degranulate in response to non-allergic triggers leading to clinical symptoms. In mastocytosis patients, such symptoms may lead to the diagnosis of a primary MCAS. The diagnosis of a concomitant allergy in mastocytosis patients is challenging. In these patients, a mixed form (primary and secondary) of MCAS may be diagnosed. These patients may also suffer from life-threatening anaphylactic reactions when exposed to allergens. In these cases, the possibility of severe side effects of in vivo provocations can sometimes also limit diagnostic evaluations. In the current article, we discuss the diagnosis and management of patients suffering from mastocytosis and concomitant MCAS, with special emphasis on novel diagnostic tests and management, including allergen microarrays, recombinant allergen analysis, basophil activation tests, optimal prophylaxis, and specific therapies.

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Prophylactic vaccination in children with mastocytosis

Pałdyna,

Pałdyna

2023

Pediatr Med Rodz

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Prophylactic vaccination is one of the fundamental elements of health policy. Poland has a universal vaccination programme, which is systematically modified depending on the changing epidemiological situation of infectious diseases, as well as current medical knowledge, which has its implications in legislation. Mastocytosis is a haematopoietic neoplasm occurring in children, usually with a benign course, limited to the skin and resolving before adolescence. However, the implementation of the general prophylactic vaccination programme in children with mastocytosis raises many concerns among doctors and parents. Vaccinations are among the exogenous agents that may cause mast cell activation and release of biologically active substances, resulting in the exacerbation of mastocytosis symptoms and an increased risk of anaphylaxis. However, the incidence of adverse effects of vaccinations in children with different forms of mastocytosis is in fact comparable to or only slightly higher than in the general population, and vaccine-related events are usually mild and local. Unfortunately, there is a lack of understanding regarding vaccinations in children with mastocytosis both among general practitioners and parents. The aims of this paper are to outline the current state of knowledge on the safety of vaccinations in this group of patients, to promote knowledge related to vaccination in patients with mastocytosis, and to emphasise that mastocytosis is not a contraindication to vaccination.

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Drug hypersensitivity reactions and allergy in patients with mastocytosis

Cited by 3 publications

References 30 publications

Cutaneous mastocytosis treatment: strategies, limitations and perspectives

Cutaneous mastocytosis treatment: strategies, limitations and perspectives

A Challenge for Allergologist: Application of Allergy Diagnostic Methods in Mast Cell Disorders

Prophylactic vaccination in children with mastocytosis

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