Systemic mast cell activation disease (MCAD, a subclass of mastocytosis), which has
a prevalence of around 17% (at least in the German population), is characterized by
accumulation of genetically altered dysfunctional mast cells with abnormal release
of these cells’ mediators. Since mast cells affect functions in potentially every organ
system, often without causing abnormalities in routine laboratory or radiologic
testing, this disease has to be considered routinely in the differential diagnosis of
patients with chronic multisystem polymorbidity of a generally inflammatory and
allergic theme. Pain in its different manifestations is a common symptom in MCAD
found in more than three-quarters of the MCAD patients. Because of the specific
mast cell-related causes of pain in MCAD it should be treated specifically, if possible,
deduced from their putative mast cell mediator-related causes. As yet, there is no
official guideline for treatment of MCAD at all. The present review focuses on mast
cell mediator-induced acute and chronic pain and the current state of analgesic drug
therapy options in MCAD. Due to the high prevalence of MCAD, many physicians
are often faced with the issue of pain management in MCAD patients. Hence, our
practical guide should contribute to the improvement of patient care.
A Practical Guide for Treatment of Pain in
Patients with Systemic Mast Cell Activation
Disease
