Diagnosis of mast cell activation syndrome: a global "consensus-2".
СтатьяПоддержка NIH: внешняя программаОбзорНазвание и аннотация: Перевод в очереди
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Afrin Lawrence B, Ackerley Mary B, Bluestein Linda S, Brewer Joseph H, Brook Jill B, Buchanan Ariana D, Cuni Jill R, Davey William P, Dempsey Tania T, Dorff Shanda R, Dubravec Martin S, Guggenheim Alena G, Hindman Kimberly J, Hoffman Bruce, Kaufman David L, Kratzer Stephanie J, Lee Theodore M, Marantz Mindy S, Maxwell Andrew J, McCann Kelly K, McKee Dwight L, Menk Otto Laurie, Pace Laura A, Perkins Dahra D, Radovsky Laurie, Raleigh Mary S, Rapaport Sonia A, Reinhold Emma J, Renneker Mark L, Robinson William A, Roland Aaron M, Rosenbloom E Scott, Rowe Peter C, Ruhoy Ilene S, Saperstein David S, Schlosser David A, Schofield Jill R, Settle Janet E, Weinstock Leonard B, Wengenroth Martina, Westaway Mark, Xi Shijun Cindy, Molderings Gerhard J
Аннотация
The concept that disease rooted principally in chronic aberrant constitutive and reactive activation of mast cells (MCs), without the gross MC neoplasia in mastocytosis, first emerged in the 1980s, but only in the last decade has recognition of "mast cell activation syndrome" (MCAS) grown significantly. Two principal proposals for diagnostic criteria have emerged. One, originally published in 2012, is labeled by its authors as a "consensus" (re-termed here as "consensus-1"). Another sizable contingent of investigators and practitioners favor a different approach (originally published in 2011, newly termed here as "consensus-2"), resembling "consensus-1" in some respects but differing in others, leading to substantial differences between these proposals in the numbers of patients qualifying for diagnosis (and thus treatment). Overdiagnosis by "consensus-2" criteria has potential to be problematic, but underdiagnosis by "consensus-1" criteria seems the far larger problem given (1) increasing appreciation that MCAS is prevalent (up to 17% of the general population), and (2) most MCAS patients, regardless of illness duration prior to diagnosis, can eventually identify treatment yielding sustained improvement. We analyze these proposals (and others) and suggest that, until careful research provides more definitive answers, diagnosis by either proposal is valid, reasonable, and helpful.