Mast cell activation and ME after dengu viral infection

[Manoj Nadgouda]

My brother has ME from last 2 yrs .ME onset has been after Dengue viral infection (DNVE). He has post exertional malaise , extremely fatigue not able to do any activities , bed bound sitwation is there , cannot eat solid food as it requires more energy for digestion so eating semi-solid / light food (rice, dal). If he eats solid fatigue increases , heart palpitation,dizziness even during digestion as If all bodys energy is used for digestion.Sudden pressure in the head, heavy head ,pressure behind the eyes, sensitivity to light, little bit of sweating and felling of intracranial pressure (ICP).
elevated Dengue IGG, IGM ( Dengu ) and IGG (VCA) EBV observed in the blood .

1. I feel is there any possibility of MAST CELL ACTIVATION after dengu viral infection as viral infection can activate inflammatory mediators . Mostly it has affected my brothers digestive system and impacted all metabolism.

2. How can I rule out MAST CELL ACTIVATION by test ? And what is treatment?

3. Any other things what I can try out ?

 

[Hip]

MCAS is hard to diagnose, as its symptoms can vary from one person to the next.

Proposed diagnostic criteria for MCAS are detailed here.

A list of MCAS symptoms can be found here.



MCAS can be treated to a degree with a combination of H1 and H2 antihistamines, and mast cell stabilizers to reduce mast cell activation:

H1 antihistamines: hydroxyzine, cetirizine
H2 antihistamines: ranitidine, famotidine
Mast cell stabilizers: NasalCrom, GastroCrom, ketotifen

 

[Hd-x]

2. How can I rule out MAST CELL ACTIVATION by test ? And what is treatment?

There is a MCAD questionnaire test availible
if a person has over 14 points in this test = there is a high chance for mastcell activiation syndrome.
Next step would be in such case doing blood tests for tryptase and mastcell mediators like f.e. Histamine, Heparine, Leukotriene, Chromagranin A, Prostraglandin D2.
If someone has high Tryptase, next step would be a biopsy to rule out Kit mutations.

 

[Lord Randal]

Dear @Manoj Nadgouda, I’m very sorry for what happened to your beloved brother, a great hug for you both!
I am not a doctor, but I can tell my experience ... I had urogenital Tuberculosis (the extremely rare UTI version) and since then my mast cells in the affected area have grown by far. I don’t know about a Dengue, but I think that these “tropical” diseases have these effects, due to being very severe in inflammatory terms.

My suggestion, the only thing I can do, is to ask to the doctor that cured him while he had Dengue: only he can know what are the long-term effects of Dengue and how to treat them.

I sincerely wish and hope your brother will get better soon!