Mast cell tumor history and symptoms: Difference between revisions

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==Overview==
==Overview==
==History and Symptoms==
==History and Symptoms==
Clinical pattern depends on mast cells burden in different organs and release of clinically relevant mediators such as [[histamine]], [[leukotrienes]], [[tryptase]], and [[heparin]].<ref name="KoenigMorel2008">{{cite journal|last1=Koenig|first1=Martial|last2=Morel|first2=Jérôme|last3=Reynaud|first3=Jacqueline|last4=Varvat|first4=Cécile|last5=Cathébras|first5=Pascal|title=An unusual cause of spontaneous bleeding in the intensive care unit – mastocytosis: a case report|journal=Cases Journal|volume=1|issue=1|year=2008|pages=100|issn=1757-1626|doi=10.1186/1757-1626-1-100}}</ref> There is considerable heterogeneity in the presentation of mastocytosis, and in the rate of disease progression. Clinical features include:<ref name=radiopaedia>Mastocytosis. Dr Alexandra Stanislavsky. Radiopaedia.org 2015. http://radiopaedia.org/articles/mastocytosis Accessed on February 29, 2016</ref><ref name=DMJ>{{Citation |last= |first= Christen Lykkegaard Andersen1|second= Thomas Kielsgaard Kristensen2|Third= Marianne Tang Severinsen|Fourth= Michael Boe Møller|Fifth= Hanne Vestergaard|Sixth= Olav J. Bergmann|Seventh= Hans Carl Hasselbalch|Eigth= Ole Weis Bjerrum| year= 2012|title= Systemic mastocytosis – a systematic review|publisher= Danish Medical Journal |publication-place= |page= |url= http://www.danmedj.dk/portal/pls/portal/!PORTAL.wwpob_page.show?_docname=8920881.PDF |accessdate= March 2nd, 2016}}</ref>
Symptoms of mast cell tumor depends on mast cells burden in different organs and release of clinically relevant mediators such as [[histamine]], [[leukotrienes]], [[tryptase]], and [[heparin]].<ref name="KoenigMorel2008">{{cite journal|last1=Koenig|first1=Martial|last2=Morel|first2=Jérôme|last3=Reynaud|first3=Jacqueline|last4=Varvat|first4=Cécile|last5=Cathébras|first5=Pascal|title=An unusual cause of spontaneous bleeding in the intensive care unit – mastocytosis: a case report|journal=Cases Journal|volume=1|issue=1|year=2008|pages=100|issn=1757-1626|doi=10.1186/1757-1626-1-100}}</ref> There is considerable heterogeneity in the presentation of mastocytosis, and in the rate of disease progression. Clinical features include:<ref name=radiopaedia>Mastocytosis. Dr Alexandra Stanislavsky. Radiopaedia.org 2015. http://radiopaedia.org/articles/mastocytosis Accessed on February 29, 2016</ref><ref name=DMJ>{{Citation |last= |first= Christen Lykkegaard Andersen1|second= Thomas Kielsgaard Kristensen2|Third= Marianne Tang Severinsen|Fourth= Michael Boe Møller|Fifth= Hanne Vestergaard|Sixth= Olav J. Bergmann|Seventh= Hans Carl Hasselbalch|Eigth= Ole Weis Bjerrum| year= 2012|title= Systemic mastocytosis – a systematic review|publisher= Danish Medical Journal |publication-place= |page= |url= http://www.danmedj.dk/portal/pls/portal/!PORTAL.wwpob_page.show?_docname=8920881.PDF |accessdate= March 2nd, 2016}}</ref>


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Revision as of 20:12, 2 March 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

History and Symptoms

Symptoms of mast cell tumor depends on mast cells burden in different organs and release of clinically relevant mediators such as histamine, leukotrienes, tryptase, and heparin.[1] There is considerable heterogeneity in the presentation of mastocytosis, and in the rate of disease progression. Clinical features include:[2][3]

Type Symptoms

Skin symptoms

Most common in urticaria pigmentosa

  • Pruritic cutaneous lesions

Mast cell reslease symptoms

Observed in both cutaneous mastocytosis and systemic mastocytosis

  • Hypotension
  • Flushing
  • Itching
  • Syncope
  • Abdominal discomfort
  • Vomiting
  • Diarrhea

Non cutaneous organ infiltration

  • Anemia
  • Malabsorption
  • Bone pain
  • Pathological fracture
  • Weight loss



Urticaria Pigmentosa

  • Urticaria pigmentosa is the most common clinical variant in which fixed, reddish brown lesions occurring as maculo-papules, plaques, nodules, or blisters are found.[4]
  • These lesions urticate in response to physical irritation (Darier’s sign).
  • Urticaria Pigmentosa (UP) lesions tend to be larger, better delineated, and more hyperpigmented in children, as compared to adults, who tend to have numerous small lesions that coalesce to form mottled areas.
  • The trunk and thigh are more commonly involved with sparing of face, palms and soles.

Diffuse Cutaneous Mastocytosis

  • Diffuse cutaneous mastocytosis is a rare variant of childhood mastocytosis that appears as diffuse infiltrative yellow-orange xanthogranuloma-like subcutaneous nodules, or as a widespread urticarial eruption with bullae and redness.
  • The clinical course is more severe and can even be life-threatening, due to hypovolemic shock, mast cell leukemia, gastrointestinal hemorrhage, and cachexia[4]

Kinetics of blood clotting may be altered due to fibrinogenolytic and anticoagulant activities of tryptase and heparin respectively. Severe bleeding leading to the death of a patient with systemic mastocytosis due to heparin-like anticoagulant has been recently reported, and may represent a difficult diagnosis and a therapeutic challenge in the emergency room.[1]

References

  1. 1.0 1.1 Koenig, Martial; Morel, Jérôme; Reynaud, Jacqueline; Varvat, Cécile; Cathébras, Pascal (2008). "An unusual cause of spontaneous bleeding in the intensive care unit – mastocytosis: a case report". Cases Journal. 1 (1): 100. doi:10.1186/1757-1626-1-100. ISSN 1757-1626.
  2. Mastocytosis. Dr Alexandra Stanislavsky. Radiopaedia.org 2015. http://radiopaedia.org/articles/mastocytosis Accessed on February 29, 2016
  3. Systemic mastocytosis – a systematic review (PDF), Danish Medical Journal, 2012, retrieved March 2nd, 2016 Unknown parameter |Sixth= ignored (help); Unknown parameter |second= ignored (help); Unknown parameter |Seventh= ignored (help); Unknown parameter |Eigth= ignored (help); Unknown parameter |Fourth= ignored (help); Unknown parameter |Fifth= ignored (help); Unknown parameter |Third= ignored (help); |first1= missing |last1= in Authors list (help); Check date values in: |accessdate= (help)
  4. 4.0 4.1 Ferrante, Giuliana; Scavone, Valeria; Muscia, Maria; Adrignola, Emilia; Corsello, Giovanni; Passalacqua, Giovanni; La Grutta, Stefania (2015). "The care pathway for children with urticaria, angioedema, mastocytosis". World Allergy Organization Journal. 8 (1): 5. doi:10.1186/s40413-014-0052-x. ISSN 1939-4551.

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