Open AccessA Practical Guide for Treatment of Pain in Patients with Systemic Mast Cell Activation Disease
Author(s) -
Stefan Wirz,
Gerhard J. Molderings
Publication year - 2017
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.20.5.e849
Subject(s) - medicine , systemic mastocytosis , mast cell , disease , guideline , population , chronic pain , analgesic , dysfunctional family , immunology , inflammatory mediator , intensive care medicine , inflammation , pathology , pharmacology , psychiatry , environmental health
Systemic mast cell activation disease (MCAD, a subclass of mastocytosis), which hasa prevalence of around 17% (at least in the German population), is characterized byaccumulation of genetically altered dysfunctional mast cells with abnormal releaseof these cells’ mediators. Since mast cells affect functions in potentially every organsystem, often without causing abnormalities in routine laboratory or radiologictesting, this disease has to be considered routinely in the differential diagnosis ofpatients with chronic multisystem polymorbidity of a generally inflammatory andallergic theme. Pain in its different manifestations is a common symptom in MCADfound in more than three-quarters of the MCAD patients. Because of the specificmast cell-related causes of pain in MCAD it should be treated specifically, if possible,deduced from their putative mast cell mediator-related causes. As yet, there is noofficial guideline for treatment of MCAD at all. The present review focuses on mastcell mediator-induced acute and chronic pain and the current state of analgesic drugtherapy options in MCAD. Due to the high prevalence of MCAD, many physiciansare often faced with the issue of pain management in MCAD patients. Hence, ourpractical guide should contribute to the improvement of patient care.