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Related Experiment Videos

Cutaneous mastocytosis with bleeding: probable heparin effect.

T F Smith, T R Welch, J B Allen

    Cutis
    |March 1, 1987
    PubMed
    Summary

    Diffuse cutaneous mastocytosis in a child caused severe gastrointestinal bleeding due to skin mast cell degranulation. This led to anticoagulation and increased vascular permeability, resolving over time.

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    Area of Science:

    • Pediatric Hematology
    • Dermatology
    • Gastroenterology

    Background:

    • Diffuse cutaneous mastocytosis (DCM) is a rare condition characterized by widespread skin mast cell infiltration.
    • Gastrointestinal bleeding is a potential complication, but its specific mechanisms in pediatric DCM require further elucidation.

    Observation:

    • A pediatric case of DCM presented with recurrent severe gastrointestinal bleeding.
    • Bleeding episodes were preceded by cutaneous bullae formation and associated with prolonged coagulation times.

    Findings:

    • Mast cell degranulation in the skin likely triggered gastrointestinal bleeding.
    • Heparin release caused anticoagulation, while histamine increased vascular permeability, contributing to bleeding severity.
    • The patient's symptoms may have stemmed from both increased mast cell numbers and enhanced mediator release, with the latter potentially improving spontaneously.

    Implications:

    • This case highlights a potential mechanism linking skin mast cell activity to significant gastrointestinal hemorrhage in pediatric DCM.
    • Understanding these pathophysiological links can inform clinical management and monitoring of affected children.
    • The spontaneous improvement suggests potential therapeutic targets related to mast cell mediator release.

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