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Mast cell activation syndrome
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==Comorbidities== Afrin et al. (2016) found the most common comorbities in MCAS, occurring in over 10% of patients, were *[[gastroesophageal reflux disease]] (GERD) 35% *[[hypertension]] 29% *multiple/atypical drug reactions 23% *[[abdominal pain]] not otherwise specified 22% *[[hysterectomy]]/oophorectomy 21% *[[hyperlipidemia]] 20% *[[cholecystectomy]] 20% *[[chemical sensitivities|environmental allergies]] 19% *tobacco abuse 18% *[[asthma]] 18% *[[diabetes|diabetes mellitus]] type 2 17% *[[hypothyroidism]] 17% *[[headache]]s 17% *[[depression]] 16% *[[sinusitis]] 16% *[[fibromyalgia]] 16% *[[anemia]] of chronic [[inflammation]] 15% *[[sleep apnea]] 15% *frequent [[upper respiratory infection|upper respiratory tract infections]] 15% *miscarriage 15% *[[sore throat|pharyngitis]] (sore throat caused by inflammation) or [[tonsillitis]] 14% *[[dysmenorrhea]] 14% *[[thromboembolism]] 13% *[[susceptibility to viruses|frequent or atypical infections]] 13% *[[obesity]] 13% *[[osteoarthritis]] 13% *[[anxiety]]/[[panic attack|panic]] 12% *vertebral disease 12% *cardiovascular malformations 12% *[[dermatitis]] 11 % *presyncope or [[syncope]] 11 % *[[interstitial cystitis]] 11 % *chronic kidney disease 10% *[[postural orthostatic tachycardia syndrome|POTS]] 10%<ref name="Afrin2016" /> MCAS is often diagnosed in patients that have been previously diagnosed with [[Ehlers-Danlos syndrome]] (EDS), a heritable connective tissue disorder, and with [[postural orthostatic tachycardia syndrome]] (POTS), a form of [[orthostatic intolerance]]. Both of these conditions are also commonly co-morbid with [[ME/CFS|ME]]. The overlap between EDS, POTS, and MCAS is thought to be due to increased tryptase production.<ref name="Milner2015">{{Citation | last = Milner | first =Joshua | title = Research Update: POTS, EDS, MCAS Genetics | date = 2015 |publisher=Dysautonomia International Conference & CME|location=Washington DC|url=https://vimeo.com/142039306}}</ref> An extra copy of the gene [[Tryptase alpha/beta 1|TPSAB1]] has been noted as a possible cause for increased [[tryptase]] production.<ref name="Lyons2016">{{Cite journal | title = Hereditary Alpha Tryptasemia: Genotyping and Associated Clinical Features | date = 2018-08-01|url=https://www.sciencedirect.com/science/article/pii/S0889856118300298|journal=Immunology and Allergy Clinics of North America|volume=38|issue=3 | pages = 483β495 | last = Lyons | first = Jonathan J.|series=Mastocytosis|language=en|doi=10.1016/j.iac.2018.04.003|pmc=PMC6411063|pmid=30007465|issn=0889-8561}}</ref> The TPSAB1 has also been implicated in [[pruritus]], unexplained, [[digestive problems|gastrointestinal symptoms]], and in other diseases including the recently discovered [[Hereditary alpha tryptasemia syndrome|Hereditary Alpha Tryptasemia]].<ref name="Cheung2015">{{Cite journal|url=http://www.jacionline.org/article/S0091-6749(14)02927-3/abstract | title = A New Disease Cluster: Mast Cell Activation Syndrome, Postural Orthostatic Tachycardia Syndrome, and Ehlers-Danlos Syndrome | last = Cheung|first = Ingrid | last2 = Vadas | first2 = Peter | date = Feb 2015 |journal=The Journal of Allergy and Clinical Immunology|volume=135|issue=2|pages=Supp AB65|via=}}</ref><ref name="niaid-FAQ">{{Cite web | title = Hereditary Alpha Tryptasemia Syndrome FAQ|website=[[National Institute of Allergy and Infectious Diseases]] | date = Oct 17, 2016|url=https://www.niaid.nih.gov/research/hereditary-alpha-tryptasemia-faq}}</ref> {{See also|Hereditary alpha tryptasemia syndrome}} A small study by Novak et al. (2022) found [[decreased cerebral blood flow]] and [[small fiber neuropathy]] were very common in MCAS patients.<ref name="Novak2022">{{Cite journal | title = Mast cell disorders are associated with decreased cerebral blood flow and small fiber neuropathy | date = 2022-03-01|url=https://www.sciencedirect.com/science/article/pii/S1081120621011558|journal=Annals of Allergy, Asthma & Immunology|volume=128|issue=3|pages=299β306.e1 | last = Novak|first = Peter | last2 = Giannetti | first2 = Matthew P. | last3 = Weller | first3 = Emily | last4 = Hamilton | first4 = Matthew J. | last5 = Castells | first5 = Mariana|language=en|doi=10.1016/j.anai.2021.10.006|issn=1081-1206}}</ref>
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