Bonadonna Patrizia, Bonifacio Massimiliano, Zanotti Roberta
Allergy Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani 1, 37126, Verona, Italy.
Curr Pharm Des. 2016;22(45):6862-6869. doi: 10.2174/1381612822666160928121857.
Mastocytosis is a clonal disease characterized by proliferation and accumulation of mast cells (MC) in different tissues, preferentially skin and bone marrow, leading to a wide variety of clinical manifestations, mainly caused by the inappropriate release of MC mediators. As a consequence, patients with mastocytosis may experience symptoms due to massive MC activation and release of mediators. Anaphylaxis is the most frequent manifestation of this phenomenon. Drugs are possible triggers of anaphylaxis in patients with mastocytosis, even though the association between mastocytosis and drug anaphylaxis does not appear to be as strong as anaphylaxis after hymenoptera sting; nevertheless, MC disorders might be ruled out in cases of severe systemic reactions to drugs. Moreover, the risk of perioperative anaphylaxis in adults appears high, mainly in patients with indolent systemic mastocytosis regardless of skin involvement. Such risk is probably lower in patients who have never experienced anaphylaxis and/or have tolerated previous general anaesthesia. However, data published about drug anaphylaxis in patients with MC disorders are scanty and currently it is not possible to provide clear recommendations.
肥大细胞增多症是一种克隆性疾病，其特征是肥大细胞（MC）在不同组织中增殖和积聚，主要在皮肤和骨髓中，导致多种临床表现，主要由MC介质的不适当释放引起。因此，肥大细胞增多症患者可能会因大量MC激活和介质释放而出现症状。过敏反应是这种现象最常见的表现。药物可能是肥大细胞增多症患者过敏反应的触发因素，尽管肥大细胞增多症与药物过敏反应之间的关联似乎不如膜翅目昆虫叮咬后的过敏反应那么强烈；然而，在药物引起严重全身反应的情况下，可能排除MC疾病。此外，成人围手术期过敏反应的风险似乎很高，主要是在惰性系统性肥大细胞增多症患者中，无论有无皮肤受累。在从未经历过过敏反应和/或耐受先前全身麻醉的患者中，这种风险可能较低。然而，关于MC疾病患者药物过敏反应的已发表数据很少，目前无法提供明确的建议。
