Open AccessUndiagnosed Systemic Mastocytosis Presenting as Postoperative Distributive Shock
Author(s) -
Juan G. Ripoll,
Matthew J. Ritter,
Thomas B. Comfere,
Mark M. Smith,
Hartzell V. Schaff,
George D. Gilkey,
Matthew A. Warner
Publication year - 2019
Publication title -
aanda practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.233
H-Index - 14
ISSN - 2575-3126
DOI - 10.1213/xaa.0000000000001093
Subject(s) - systemic mastocytosis , medicine , shock (circulatory) , anaphylaxis , presentation (obstetrics) , refractory (planetary science) , cardiopulmonary bypass , distributive property , differential diagnosis , bone marrow , tryptase , surgery , anesthesia , pathology , mast cell , immunology , allergy , physics , mathematics , astrobiology , pure mathematics
Systemic mastocytosis (SM) is a rare clinical condition resulting from a clonal proliferation of abnormal mast cells. The clinical presentation may vary from mild cutaneous manifestations to aggressive systemic symptoms including intermittent episodes of anaphylaxis. We present a case of a 69-year-old male with abrupt and recurrent episodes of anaphylaxis with refractory distributive shock following cardiac surgery with cardiopulmonary bypass. Following a complex postoperative course, a bone marrow biopsy ultimately confirmed the diagnosis. Although rare, SM should be considered in the differential diagnosis of postoperative patients with unexplained and recurrent episodes of distributive shock.