Anaphylaxis in Patients with Mastocytosis - a Prospective Study on Prevalence, Severity and Trigger Factors in 121 Patients

Brockow, Knut; Ring, Johannes; Jofer, C.

doi:10.1016/j.jaci.2005.12.1213

Cited by 5 publications

(5 citation statements)

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“…The most common triggers of anaphylactic reactions were Hymenoptera stings, food, and medications, similarly to data from previous reports. 2,6,7 What is novel in our study is that we identified the underestimated triggers of mediator-related symptoms, namely, physical factors. Symptoms of mast cell -activation provoked by physical factors were reported in 74% of the patients (n = 112).…”

Section: 30mentioning

confidence: 93%

“…3,5,6 Although the incidence of anaphylactic reactions (both immunoglobulin E [IgE]-dependent and IgE-independent) in patients with mastocytosis is significantly higher than in the general population, the frequency of atopy is similar in both populations. 7 Insect stings are considered a major cause of mast cell activation in patients with mastocytosis. It is estimated that 30% of patients with mastocytosis have anaphylactic reactions due to insect sting, 6 which are more frequent and more severe than in the general population with insect venom allergies (IVA) (1%-3%).…”

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confidence: 99%

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Risk factors for anaphylaxis in patients with mastocytosis

Górska¹,

Niedoszytko²,

Lange³

et al. 2015

Polish Archives of Internal Medicine

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Section: 30mentioning

confidence: 93%

mentioning

confidence: 99%

Risk factors for anaphylaxis in patients with mastocytosis

Górska¹,

Niedoszytko²,

Lange³

et al. 2015

Polish Archives of Internal Medicine

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“…In human mast cells, the influence of a single mutation can be seen in the expression of the D816V activating mutation in the tyrosine kinase KIT, leading to mast cell proliferation and mastocytosis [42]. Mast cell proliferation and the prevalence of episodes of hypotension in mastocytosis patients prompted studies that identified associations between systemic mastocytosis and anaphylaxis [43,44,45 • ,46]. The activating D816V KIT mutation also was recently reported in some mastocytosis patients with recurrent unexplained anaphylaxis [45 • ].…”

Section: Mutations In Signaling Componentsmentioning

confidence: 99%

Understanding the mechanisms of anaphylaxis

Peavy

Metcalfe

2008

Current Opinion in Allergy &Amp; Clinical Immunology

172

155

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Purpose of review The present review considers recent reports that identify the roles of key intermediate signaling components and mediators during and after mast cell activation and degranulation leading to anaphylaxis. Recent findings Mechanisms of anaphylaxis are becoming better understood as the interaction of several regulatory systems in the mast cell activation and degranulation signaling cascade. Multiple tyrosine kinases, activated after immunoglobulin E binding to the high-affinity receptors for immunoglobulin E (FcεRI), exert both positive and negative regulation on the signaling cascade, which may vary with genetic background or mutations in signaling proteins. Calcium influx, the essential, proximal intracellular event leading to mast cell degranulation, is controlled also by both negative and positive regulation through calcium channels. Sphingosine-1-phosphate is emerging as a newly realized mediator of anaphylaxis, acting as a signaling component within the mast cell and as a circulating mediator. Summary Anaphylaxis is a systemic reaction involving multiple organ systems, but it is believed that it may be influenced by cellular events in mast cells and basophils resulting in the release of mediators. Therefore, understanding the mechanisms of mast cell activation and degranulation is critical to understanding the mechanisms of anaphylaxis. Recent reports have identified important regulatory components of the signaling cascade and, consequently, potential targets for therapeutic intervention.

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“…In a study of tryptase levels in 193 post‐mortem samples of which seven were known to have had anaphylactic or anaphylactoid deaths the sensitivity and specificity using a cut‐off value of 10 μg/L was found to be 86% and 88%, respectively [68]. Baseline tryptase may be elevated in certain disorders including mastocytosis and patients with this condition are more susceptible to drug‐induced anaphylaxis [69].…”

mentioning

confidence: 99%

BSACI guidelines for the management of drug allergy

Mirakian

Ewan

Durham

et al. 2009

Clin Experimental Allergy

213

199

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SummaryThese guidelines have been prepared by the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI) and are intended for allergists and others with a special interest in allergy. As routine or validated tests are not available for the majority of drugs, considerable experience is required for the investigation of allergic drug reactions and to undertake specific drug challenge. A missed or incorrect diagnosis of drug allergy can have serious consequences. Therefore, investigation and management of drug allergy is best carried out in specialist centres with large patient numbers and adequate competence and resources to manage complex cases. The recommendations are evidencebased but where evidence was lacking consensus was reached by the panel of specialists on the committee. The document encompasses epidemiology, risk factors, clinical patterns of drug allergy, diagnosis and treatment procedures. In order to achieve a correct diagnosis we have placed particular emphasis on obtaining an accurate clinical history and on the physical examination, as these are critical to the choice of skin tests and subsequent drug provocation. After the diagnosis of drug allergy has been established, communication of results and patient education are vital components of overall patient management.

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Anaphylaxis in Patients with Mastocytosis - a Prospective Study on Prevalence, Severity and Trigger Factors in 121 Patients

Cited by 5 publications

References 0 publications

Risk factors for anaphylaxis in patients with mastocytosis

Risk factors for anaphylaxis in patients with mastocytosis

Understanding the mechanisms of anaphylaxis

BSACI guidelines for the management of drug allergy

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