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Increased plasma calcitonin levels in systemic mast cell disease
M W Yocum1, J H Butterfield, H Gharib
1Division of Allergic Diseases and Internal Medicine, Mayo Clinic Rochester, Minnesota 55905.
Mayo Clinic Proceedings
|October 1, 1994
Summary
Aspirin desensitization in systemic mast cell disease (SMCD) can trigger severe reactions. This study observed a paradoxical increase in calcitonin levels during a patient's anaphylactoid reaction to aspirin.
Area of Science:
- Mast Cell Biology
- Pharmacology
- Endocrinology
Background:
- Systemic mast cell disease (SMCD) involves abnormal mast cell activity.
- Aspirin therapy, while beneficial for some SMCD symptoms like flushing, can paradoxically induce severe reactions in a subset of patients.
- Understanding these paradoxical reactions is crucial for patient management.
Observation:
- A 34-year-old male patient with SMCD experienced severe flushing and hypotension.
- Attempted aspirin desensitization led to an anaphylactoid reaction, characterized by hypotension, cramping, and flushing.
- Significant elevations in plasma calcitonin, serum tryptase, urinary histamine, and N-methylimidazoleacetic acid were observed during and after the reaction.
Findings:
- The patient exhibited elevated baseline levels of plasma calcitonin, urinary histamine, and N-methylimidazoleacetic acid.
- Pentagastrin stimulation further increased plasma calcitonin levels.
- Aspirin desensitization triggered a substantial increase in plasma calcitonin, exceeding normal limits during the anaphylactoid reaction.
Implications:
- Human mast cells may play a role in calcitonin production or secretion.
- The findings suggest a potential link between mast cell activation, calcitonin, and anaphylactoid reactions in SMCD.
- Further research is needed to elucidate the mechanisms of aspirin-induced reactions and the role of calcitonin in SMCD.