From the Research
Mast cell activation syndrome (MCAS) can cause anaphylaxis in a significant proportion of patients, with the frequency varying widely among individuals, and approximately 20-30% of MCAS patients experiencing at least one anaphylactic episode in their lifetime, as supported by the most recent study 1. The risk of anaphylaxis in MCAS depends on individual triggers, the severity of the condition, and how well it's managed. Patients with MCAS should always carry emergency medications including epinephrine auto-injectors (like EpiPen or Auvi-Q, typically 0.3mg for adults or 0.15mg for children), antihistamines (such as diphenhydramine 25-50mg), and oral corticosteroids (like prednisone 40-60mg) for prompt treatment of severe reactions, as recommended by recent guidelines 2. Some key points to consider in the management of MCAS and prevention of anaphylaxis include:
- Identifying and avoiding personal triggers is crucial for prevention, as emphasized in 3.
- MCAS causes anaphylaxis through excessive mast cell degranulation, releasing large amounts of histamine and other inflammatory mediators that trigger systemic reactions affecting multiple body systems simultaneously, unlike the more localized symptoms that characterize typical MCAS flares, as explained in 4.
- The diagnosis of MCAS should be considered in the differential diagnosis of patients presenting with recurrent anaphylaxis without a clear cause, as discussed in 5.
- A personalized treatment approach, taking into account the individual's specific condition, triggers, and comorbidities, is essential for optimal management of MCAS and prevention of anaphylaxis, as highlighted in 2 and 3.