Table 1.
Common symptoms of mast cell activation syndrome. There are many heterogenous phenotypes that vary according to mast cell location, number, and ability to degranulate specific mediators. Symptoms may be continuous or intermittent and be of various levels of severity.
| Constitutional | Fatigue, subjective hyperthermia and/or hypothermia, sweats, change in appetite, weight gain/loss, chemical/physical sensitivities, poor healing |
| Dermatologic | Urticaria, itch, flushing, hemangiomas with itch/pain, various rashes, telangiectasias, striae, skin tags, folliculitis, ulcers, eczema, angioedema, alopecia, onychodystrophy |
| Ophthalmologic | Irritated, “dry” eyes, difficulty focusing, blepharospasm |
| Otologic | Tinnitus, hearing loss, coryza, rhinitis, nasal congestion, epistaxis |
| Oropharyngeal | Pain, burning, leukoplakia, ulcers, angioedema, dysgeusia, dental and/or periodontal inflammation/decay |
| Lymphatic | Lymphadenopathy, rare splenomegaly |
| Pulmonary | Dry cough, dyspnea (difficulty taking a deep breath), wheezing, obstructive sleep apnea |
| Cardiovascular | Presyncope, hypertension, blood pressure lability, palpitations, edema, chest pain, allergic angina (Kounis syndrome) |
| Gastrointestinal | Dyspepsia, gastroesophageal reflux, abdominal pain, nausea, vomiting, diarrhea and/or constipation, gastroparesis, angioedema, dysphagia (usually proximal), bloating (post-prandial or spontaneous), malabsorption |
| Genitourinary | Menorrhagia, pelvic pain, endometriosis, vulvodynia, vaginitis, dysmenorrhea, miscarriages, infertility, dysuria |
| Musculoskeletal | Myalgias, migratory bone/joint pain, osteopenia/osteoporosis |
| Neurologic | Headache, migraine, sensory neuropathies, dysautonomia, episodic weakness, seizure disorders, non-epileptic seizures, cognitive dysfunction, insomnia, hypersomnolence, restless leg syndrome |
| Psychiatric | Depression, anger/irritability, mood lability, anxiety, panic, obsession–compulsion, attention deficit/hyperactivity |
| Hematologic | Easy bruising, polycythemia, anemia |
| Immunologic | Hypersensitivity reactions, increased risk for malignancy and autoimmunity, impaired healing, increased susceptibility to infection |