Title:Mast Cell Disorders In Drug Hypersensitivity
VOLUME: 22 ISSUE: 45
Author(s):Patrizia Bonadonna, Massimiliano Bonifacio and Roberta Zanotti
Affiliation:Allergy Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani 1, 37126, Verona
Keywords:Mastocytosis, drug allergy, tryptase, mast cell.
Abstract:Mastocytosis is a clonal disease characterized by proliferation and accumulation
of mast cells (MC) in different tissues, preferentially skin and bone marrow, leading to a
wide variety of clinical manifestations, mainly caused by the inappropriate release of MC
mediators. As a consequence, patients with mastocytosis may experience symptoms due to
massive MC activation and release of mediators. Anaphylaxis is the most frequent manifestation
of this phenomenon. Drugs are possible triggers of anaphylaxis in patients with mastocytosis,
even though the association between mastocytosis and drug anaphylaxis does not
appear to be as strong as anaphylaxis after hymenoptera sting; nevertheless, MC disorders
might be ruled out in cases of severe systemic reactions to drugs. Moreover, the risk of perioperative
anaphylaxis in adults appears high, mainly in patients with indolent systemic mastocytosis
regardless of skin involvement. Such risk is probably lower in patients who have
never experienced anaphylaxis and/or have tolerated previous general anaesthesia. However,
data published about drug anaphylaxis in patients with MC disorders are scanty and currently it is not possible to
provide clear recommendations.
