Non-Allergic, Mastocytosis Associated Rhinitis

[nanonug]

Non-Allergic, Mastocytosis Associated Rhinitis

Abstract

Background

Systemic mastocytosis (SM) is a clonal proliferative disorder of mast cells (MC) that causes pathological accumulation of mast cells in various tissues, which results in clinical symptoms (e.g. diarrhoea, urticaria) due to MC mediator release. Previous studies have shown that up to fifty percent of rhinitis symptoms in SM patients are non-allergic and it has been assumed that these nasal complaints in SM patients are due an increased nasal mast cell burden. Nevertheless, to date there is no data supporting this hypothesis.
Objective

The study aims to investigate if the presence of allergy-suggesting nasal complaints in non-allergic SM patients is correlated to objective measure of nasal mast cell burden.
Patients and methods

Eleven adult patients with systemic mastocytosis underwent a comprehensive rhinologic work-up. All patients fulfilled the clinical ARIA criteria for rhinitis. The allergologic work-up included serologic allergy testing, determination of tryptase levels (serum and nasal secretion), skin prick testing and nasal provocation testing.
Results

Ten out of eleven SM patients with clinical persistent allergic rhinitis were found to be non-allergic. In these patients, the most predominant symptoms were rhinorrhea, sneezing, and itching. All three symptoms were strongly correlated with the nasal tryptase level but not to the level of serum tryptase.
Conclusion and Clinical relevance

Non-allergic persistent nasal complaints in systemic mastocytosis were significantly correlated to elevated nasal tryptase level as a measure of local MC burden. Furthermore, elevated nasal tryptase correlated with persistent rhinorrhea, sneezing, and itching as predominant symptoms, which seems to characterize a non-allergic mastocytosis associated rhinitis (NAMAR) in systemic mastocytosis.
© 2012 Blackwell Publishing Ltd

 

[taniaaust1]

Interesting.. i had no idea there was a nasal tryptase test.. or would that only be a research test?

(Ive only had blood tryptase masto tesing done). I sometimes get a blocked up nose with my symptoms but find large dose of vitamin C helps it when I do.

 

[Ocean]

So interesting! I get flushing and nasal congestion after eating triggering foods. I'm curious what I'll learn if I can make it to a specialist. I hope I'll find some relief because I get frequent uncomfortable episodes. I've been tested for tryptase but not in the nose!

 

[nanonug]

Interesting.. i had no idea there was a nasal tryptase test.. or would that only be a research test?

I found one lab that does it: ImmunoCAP Tryptase.

(Ive only had blood tryptase masto tesing done).

I remebre your mentioning it in the past. One of the interesting things with mast cell activation syndrome is that tryptase is usually normal.

 

[nanonug]

I get flushing and nasal congestion after eating triggering foods.

Same here. All foods are triggering foods for me, though.

I've been tested for tryptase but not in the nose!

If you go to a specialist, make sure to go beyond tryptase, though, as this is usually within the normal range in cases of mast cell activation syndrome.

 

[xchocoholic]

Thanks for posting this and the other articles on mast cells.

Is this study about having nasal drip without any other symptom ? I get this in cold weather.

I had chronic runny nose, sneezing, post hasal drip when I was eating the SAD. Now I know
dairy triggers shiners after a few days of eating it and soy causes phlegm in my throat within minutes.
I just tried some herbal tea with trace amounts of soy and started choking on phlegm.

Fwiw, I havea freind who's only allergic to her cats if she eats dairy. Somehow it affects her
imune system so that her allergies flare.

I was still allergic, phlegm and stuffy nose mainly, to my dogs after eliminating my food intolerances
and needed to bath them at least once a week in Daw dish soap. And wash all their linens. My eyes
would get goopy if my face got too close to them.

Tc .. X

 

[Ocean]

Same here. All foods are triggering foods for me, though.



If you go to a specialist, make sure to go beyond tryptase, though, as this is usually within the normal range in cases of mast cell activation syndrome.

Yeah mine was normal but my doctor (endocrinologist) admitted that to dig deeper I'd have to see a specialist since that is not his field. I hope I will be able to go soon. I will definitely update here when I do.

 

[searcher]

My nose is stuffy all the time, especially at night. It's not like normal allergies because my nose isn't runny and I don't sneeze too often-- it's just stuffed. I know some foods are affecting me, but unfortunately I think normal indoor "triggers" are also causing problems.
Have any of you tried nasalcrom? It's OTC cromolyn. I have tried ketotifen for my eye burning but haven't tried nasalcrom yet.
taniaaust1 - Thanks for the Vitamin C tip. I usually take high doses but have been slacking, and that has coincided with my nasal stuffiness getting bad enough to affect my sleep.

 

[Ocean]

Searcher, I have eye burning watering too and a lot of nasal congestion. Interesting that we share this symptom. I should try nasalcrom. I think I tried it in the past but I don't remember if I tried it for long enough for it to have effect. I've never heard of ketotifen, I'll have to look it up. My congestion affects my sleep too.

 

[xchocoholic]

Zyrtec (Wal-zyr) is helping my stuffy nose but I need to take 25 - 30 mg. Mine appears to be from swelling not
drainage. I have angioedema that's causing pelvic and bladder pain too. Wal-zyr is helping that too. Kow.

I just saw that Walgreens has an allergy med for eyes called wal-zyr too. I'm not sure if brand name Zyrtec has one.

Nasalcrom only helps me if my nose I running non stop. Otherwise it dries out my sinuses too much.

Too much Benadryl dries out my sinuses and my brain. Lol .. Tc .. X

 

[perchance dreamer]

Nasalcrom helps my allergies a little bit, but I find it more thick and viscous than other nasal sprays. It seems to reduce breathing space from my already stuffy nose.

My ENT asks that patients refrain from using Nasalcrom a couple of days before coming in for an appt. On examination, Nasalcrom can look like infection.