Recognition and Management of Medication Excipient Reactivity in Patients With Mast Cell Activation Syndrome.

Jill R Schofield, Lawrence B Afrin

Journal: The American journal of the medical sciences 2019;357(6):507-511

PMID: 31126513

Full Text on Elsevier Science View on PubMed

Abstract

Mast cell activation syndrome (MCAS) is a complex disorder hallmarked by chronic multisystem inflammatory, allergic and growth dystrophic phenomena caused by inappropriate mast cell activation. MCAS has been estimated to affect as many as 17% of the population with a severity ranging from mild to life-threatening. MCAS patients are more sensitive than the average person to chemicals in the environment, including the nondrug ("inactive") ingredients (excipients) in medications and supplements. Excipient reactivity may explain unusual side effects to medications health professionals often find puzzling, such as the patient who appears intolerant of prednisone, acetaminophen, levothyroxine, or a vitamin. We present a series of patients with MCAS to illustrate important points regarding excipient reactivity which may be useful in everyday practice.

Address: Center for Multisystem Disease, Denver, Colorado; University of Colorado School of Medicine, Aurora, Colorado. Electronic address: [email protected].; Armonk Integrative Medicine, Armonk, New York.

DOI: 10.1016/j.amjms.2019.03.005

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MeSH Terms: Adolescent, Excipients, Female, Humans, Male, Mastocytosis, Middle Aged, Young Adult