This summary was compiled from the tweets posted by the following allergists/immunologists who attended the 2012 annual meeting of the American Academy of Allergy Asthma and Immunology (AAAAI): Dr. Melinda Rathkopf @mrathkopf. The tweets were labeled #AAAAI. The text was edited and modified by me.Role of mast cells in allergy had remained undetermined until the discovery of IgE in 1966. Then, IgE purified from many Liters of plasma, which had been donated from a patient with fatal myeloma, was distributed to researchers all over the world (http://buff.ly/12sD3cO).
Clinical Aspects of Mast Cell Dysfunction were discussed by Dean Metcalfe, MD:
The average 70 kg man has about 100 grams of mast cells.
Mastocytosis is defined by the presence of excessive number of mast cells in skin, bone marrow, GI tract, lymph nodes, liver and spleen. Activating mutations in KIT promote mast cell proliferation.
There is 1:20 risk of someone with mastocytosis of having anaphylaxis. Risk in general population is 1:5,000.
When to do a bone marrow biopsy on patient with sting anaphylaxis?
When there is Increased serum tryptase (>11), organomegaly, peripheral blood abnormalities or persistent severe reactions (use your clinical judgement).
References
Criteria for Dx of Mast Cell Activation Disorder. Int Arch Allergy Immunol 157:215-225.
Mast Cell Activation Syndrome: proposed diagnostic criteria. J Allergy Clin Immunol 126:1099-1104.
Mast Cell Activation Disorders - 2014 free full text review http://buff.ly/1kPDdzo
Proposed diagnostic algorithm for patients with suspected mastocytosis. Allergy, 2014 http://buff.ly/1hZ4ayz
Mast Cell Disorders (presentation on Google drive):