Anaphylaxis to quinolones in mastocytosis: Hypothesis on the mechanism

Genetic study for KIT mutation was not done. [...]SM without cutaneous involvement was diagnosed. [...]the frequency of clonal mast-cell disease in screened subjects with HVA ranges from 1% to 7.9%.4,5 The risk of anaphylaxis in mastocytosis increases with higher levels of tryptase. [...]more severe...

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Veröffentlicht in:The journal of allergy and clinical immunology in practice (Cambridge, MA) MA), 2019-07, Vol.7 (6), p.2089-2090
Hauptverfasser: Giavina-Bianchi, Pedro, Gonçalves, Danilo Gois, Zanandréa, Andressa, Borges de Castro, Raísa, Garro, Laila Sabino, Kalil, Jorge, Castells, Mariana
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container_issue 6
container_start_page 2089
container_title The journal of allergy and clinical immunology in practice (Cambridge, MA)
container_volume 7
creator Giavina-Bianchi, Pedro
Gonçalves, Danilo Gois
Zanandréa, Andressa
Borges de Castro, Raísa
Garro, Laila Sabino
Kalil, Jorge
Castells, Mariana
description Genetic study for KIT mutation was not done. [...]SM without cutaneous involvement was diagnosed. [...]the frequency of clonal mast-cell disease in screened subjects with HVA ranges from 1% to 7.9%.4,5 The risk of anaphylaxis in mastocytosis increases with higher levels of tryptase. [...]more severe Hymenoptera HSRs are also associated with higher baseline serum tryptase levels in patients without SM.4,5 Our patient had an abnormal serum tryptase level (17.7 μg/L). [...]the diagnosis is challenging, because drug-specific sIgE tests are unavailable and skin testing presents undetermined sensitivity and specificity.3 Quinolones are one of the substances that may activate mast cells through MRGPRX2, resulting in non–IgE-mediated release of mediators, as described above.7 In conclusion, the excess of mast cells and their MRGPRX2 receptors in patients with mastocytosis may induce anaphylaxis on activation by quinolones.
doi_str_mv 10.1016/j.jaip.2019.01.059
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[...]SM without cutaneous involvement was diagnosed. [...]the frequency of clonal mast-cell disease in screened subjects with HVA ranges from 1% to 7.9%.4,5 The risk of anaphylaxis in mastocytosis increases with higher levels of tryptase. [...]more severe Hymenoptera HSRs are also associated with higher baseline serum tryptase levels in patients without SM.4,5 Our patient had an abnormal serum tryptase level (17.7 μg/L). 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subjects Anaphylaxis
Antibiotics
Disease
Immunotherapy
Mast cells
Mastocytosis
Patients
Quinolones
Skin tests
Tryptase
title Anaphylaxis to quinolones in mastocytosis: Hypothesis on the mechanism
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