Proposed Diagnostic Algorithm for Patients with Suspected Mast Cell Activation Syndrome

Area of Science:

• Immunology
• Allergy and Clinical Immunology
• Internal Medicine

Background:

• Mast cell activation (MCA) is common, with mild symptoms often manageable by medication.
• Severe cases may suggest mast cell activation syndrome (MCAS), but overt MCAS is rare.
• Many patients suspected of MCAS have other conditions or milder MCA without meeting MCAS criteria.

Purpose of the Study:

• To propose a diagnostic algorithm for clinically relevant systemic MCA.
• To aid in documenting or excluding mast cell activation syndrome (MCAS).
• To guide clinicians in considering severe allergy and systemic mastocytosis as underlying causes of MCAS.

Main Methods:

• Development of a diagnostic algorithm for suspected mast cell activation syndrome (MCAS).
• The algorithm aims to differentiate MCAS from other conditions and identify underlying causes.
• Focus on guiding clinicians through the diagnostic process for patients with suspected MCA/MCAS.

Main Results:

• The proposed algorithm facilitates the suspicion of clinically relevant systemic MCA.
• It assists in the documentation or exclusion of mast cell activation syndrome (MCAS).
• The algorithm helps identify severe allergy and systemic mastocytosis as potential underlying diagnoses.

Conclusions:

• The diagnostic algorithm provides a structured approach to evaluating patients with suspected mast cell activation syndrome (MCAS).
• It aims to reduce misdiagnoses and unnecessary referrals by clarifying MCA and MCAS criteria.
• Further validation is needed, but the algorithm is anticipated to improve MCAS patient management.