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  • Dinkar Bakshi

Mast cell activation syndrome

Updated: Feb 24

Mast Cell Activation Syndrome (MCAS) is a complex and relatively newly recognized medical condition that involves the abnormal activation and degranulation of mast cells, which are immune cells that play a crucial role in the body's immune response and inflammatory processes. In MCAS, mast cells release excessive amounts of various chemical mediators, such as histamine and cytokines, even in response to minor triggers or without apparent triggers. This inappropriate activation can lead to a wide range of symptoms and can be challenging to diagnose and manage.

Here are key points to understand about Mast Cell Activation Syndrome:


The symptoms of MCAS can vary widely among individuals and may affect multiple organ systems. Common symptoms include:

Skin reactions: Hives, itching, flushing, and angioedema (swelling of the deeper layers of the skin).

Gastrointestinal symptoms: Abdominal pain, diarrhea, nausea, and vomiting.

Respiratory symptoms: Wheezing, shortness of breath, and nasal congestion.

Cardiovascular symptoms: Rapid heart rate (tachycardia) and low blood pressure (hypotension).

Neurological symptoms: Headaches, brain fog, and dizziness.

Symptoms can be episodic and may mimic those of other conditions, making diagnosis challenging.


MCAS symptoms can be triggered by a variety of factors, including:

Physical stress, such as exercise.

Temperature changes.

Emotional stress.

Certain foods and food additives.

Medications and drugs.

Infections and environmental factors.

Triggers can vary from person to person, and identifying specific triggers can be part of the diagnostic process.


Diagnosing MCAS can be challenging due to the variability of symptoms and the absence of a specific diagnostic test. Diagnosis often involves a combination of clinical evaluation, symptom history, and laboratory tests.

Laboratory tests may include measuring levels of mast cell mediators, such as tryptase, histamine, and prostaglandins, in blood or urine samples.

The diagnosis of MCAS is typically made by a healthcare provider with expertise in allergic and immunologic disorders.

Treatment and Management:

The primary goal of MCAS treatment is to manage and alleviate symptoms. This often involves a multi-faceted approach:

Trigger avoidance: Identifying and avoiding triggers, when possible, is an essential part of managing MCAS.

Medications: Antihistamines, mast cell stabilizers, and medications that block the action of specific mast cell mediators (e.g., leukotriene modifiers) may be prescribed.

Symptomatic relief: Medications to alleviate specific symptoms (e.g., antihistamines for itching) may also be used.

Consultation with specialists: Collaboration with allergists, immunologists, and other specialists may be necessary for comprehensive care.


MCAS is a chronic condition, and management often requires ongoing monitoring and treatment.

While MCAS can be challenging to manage, many individuals can achieve symptom control and lead relatively normal lives with appropriate care.

It's important for individuals experiencing symptoms consistent with MCAS to seek evaluation and diagnosis by a healthcare provider with expertise in mast cell disorders and immunology. Proper diagnosis and management can significantly improve the quality of life for those with this condition.

Book your appointment with Dr Bakshi one of the few formally trained top allergy cosultants in London and Birmingham, head to British Allergy Clinic, the best private allergy clinic that provides comprehensive care and treatment for all your allergies.

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