Table 3.

Triggering Factors in Pediatric Mastocytosis

Physical stimuli

Frequent

Heat

Sudden changes of temperature

Rubbing/pressure of skin lesions

Scalp trauma (children with scalp involvement)

Infrequent

Cold

Sunlight

Emotional factors

Stress,

Anxiety

Sleep deprivation

Infectious diseases with fever

Viral (Esp. respiratory and gastrointestinal)

Bacterial (bronchitis, pneumonia)

Drugs*

Non-steroidal anti-inflammatory drugs

Morphine and derivatives

Cough medication: dextromethorphan

Miscellaneous

Dental procedures

Vaccinations

Surgery

Associated allergic diseases **

1. Responses greatly vary from patient to patient. 2. Patients with known sensitivities must wear a Medic alert bracelet or necklace.

^*If patients have not taken these drugs before, provocation test may be performed under close medical supervision.

^**Foods, environmental allergens and other factors may exacerbate or precipitate mast cell activation in mastocytosis patients.