A Treatment Approach for Severe Pain in Mast Cell Activation Syndrome: A Case Report.

Chronic pain is a common and disabling feature of mast cell activation syndrome (MCAS), with no established treatment paradigm. Cannabidiol (CBD) has recently shown potential to suppress mast cell activation and degranulation. We present a unique case in which widespread, severe, refractory MCAS-related pain was treated with a combination of orphenadrine and CBD oil. Marked improvements were observed at 4 and 20 weeks posttreatment, with pain severity and interference scores reduced by 56% and 87%, respectively. This therapeutic combination may represent a promising new adjuvant approach for managing pain in MCAS and warrants further investigation. .