Mastocytosis and intestinal malabsorption

Systemic mastocytosis involving the gastrointestinal tract: clinicopathologic and molecular study of five cases

“…These findings are similar to those reported in other small series and case reports. 2,[5][6][7][8][9][10][11]13,14,[16][17][18][21][22][23]26,30,31 Malabsorption, which occurred in two patients in our series is well described in systemic mastocytosis, 2,5,7,9,10,16,23,30,31 occurring in 5-30% of patients. 30,32 While all patients in our series were women, the literature indicates an equal sex distribution for systemic mastocytosis in general 33 and for those cases with direct gastrointestinal involvement.…”

“…30,32 While all patients in our series were women, the literature indicates an equal sex distribution for systemic mastocytosis in general 33 and for those cases with direct gastrointestinal involvement. [5][6][7][8][9][10][11]13,[16][17][18][19][21][22][23]31 Endoscopically and grossly, the most frequent and distinctive finding in our series was that of mucosal nodularity (present in four of five patients). Such nodularity has been documented by others, both radiologically and endoscopically.…”

“…Such heavy eosinophil infiltrates in gastrointestinal biopsies from systemic mastocytosis patients have documented by others. 8,10,14,16,18 The use of special stains to highlight mast cells is invaluable in this setting as most other causes of mucosal eosinophil infiltrates (including eosinophilic gastroenteritis) are not associated with increased mast cells. 14 An exception is parasitic infestation that may be associated with a prominence of both eosinophils and mast cells.…”

“…Indeed, three of five patients in our series had colonoscopic findings considered to be consistent with inflammatory bowel disease (although one had coexistent ulcerative colitis). The issue may be further complicated by the fact that the lamina propria infiltrate in systemic mastocytosis may include variable numbers of lymphocytes and plasma cells, [6][7][8]10,14,23,31,39 and that inflammatory bowel disease may show a prominence of mast cells or eosinophils. [40][41][42] A recent report of systemic mastocytosis mimicking Crohn's disease highlights the potential for misdiagnosis of these conditions.…”

Gastrointestinal involvement and manifestations in systemic mastocytosis

“…[31][32][33][34][35][36] A few cases of total villus atrophy are reported. 37,38 Furthermore, an inflammatory infiltrate in the lamina propria has been observed in many cases. This infiltrate consists essentially of plasma cells and eosinophils, 32,35,37,38 and in some cases of a large number of mast cells expressing CD2 and/or CD25.…”