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A preliminary assessment of behavioral problems in children with mastocytosis
K E McFarlin1, M J Kruesi, D D Metcalfe
1Child Psychiatry Branch, National Institute of Mental Health, Bethesda, Maryland.
Insights
Pediatric mastocytosis (a condition causing hives) does not appear to cause unique behavioral issues. Children with this condition show behavioral difficulties similar to other medically ill children.
Area of Science:
- Pediatric Psychology
- Dermatology
- Allergy and Immunology
Background:
- Mastocytosis is a rare disorder characterized by abnormal mast cell accumulation.
- Behavioral pathology in adults with mastocytosis has been documented.
- The behavioral impact of mastocytosis in pediatric populations remains less understood.
Purpose of the Study:
- To review adult mastocytosis behavioral pathology.
- To assess pediatric mastocytosis patients for similar behavioral pathology.
- To determine if histamine overproduction uniquely impacts child behavior.
Main Methods:
- Evaluated 12 pediatric mastocytosis patients (ages 2-11).
- Utilized parent-reported Childhood Behavior Checklist (CBCL) and teacher reports.
- Compared scores to normative data and other medically ill pediatric groups.
Main Results:
- Mean CBCL scores did not significantly differ from norms.
- Four of ten parents reported elevated individual behavior ratings.
- Parental ratings were comparable to other medically ill children; teacher ratings were not pathological.
Conclusions:
- No clear excess of behavioral pathology identified in pediatric mastocytosis.
- Behavioral difficulties are nonspecific and similar to other medically ill groups.
- No unique behavioral pattern linked to histamine overproduction was found.
Objective:
The objectives of this study were to 1) review mastocytosis in terms of the behavioral pathology in adults, and 2) to assess a group of pediatric patients with mastocytosis to determine if similar behavioral pathology is evident.
Method:
Twelve children ages two to eleven referred to the NIH, a tertiary referral center for mastocytosis, were studied. Questionnaires were mailed for assessment of the child's behavior: parents completed the Childhood Behavior Checklist (CBCL) and children four years of age or more were evaluated by their teachers via the Child Behavior Checklist-Teacher Report form. Scores were compared to published normative data and to published data from other medically ill pediatric groups. Pathology was defined as present if the child scored greater than two standard deviations above published age and sex-matched norms.
Results:
Mean factor scores on the CBCL for children with mastocytosis did not differ significantly from published norms, but individual ratings by parents were significantly elevated in four of ten subjects. Moreover, CBCL ratings by parents were similar to those seen in other medically ill pediatric groups. None of the teacher ratings were in the pathological range.
Conclusions:
The results of this study indicate that no clear excess of pathology exists in children with mastocytosis. Individual children treated with antihistamines for mastocytosis seem to have a nonspecific increase in behavioral difficulties at rates similar to other medically ill groups. No unique behavioral pattern implicating histamine overproduction was identified.