idiopathic anaphylaxis information center

a resource for people with ia and other mast cell disorders


Introduction |


Third spacing | But is it? | Flushing |

Mast cells

Carboxypeptidase | Histamine | New kind of SAD? |

Other topics

Rosacea | Probiotic drinks

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Introduction to articles


Beginning in 2006, I wrote a number of articles for the quarterly newsletter published by the Mastocytosis Society (TMS), The Mastocytosis Chronicles.

These articles were carefully researched and written, and the original version of most of these articles was reviewed by one or more doctors on the TMS Medical Advisory Board. Since these articles address issues of interest to people who have idiopathic anaphylaxis, mastocytosis, or a mast cell activation disorder, I decided to make them available through this site. I have used this opportunity to update, revise, and fact– and reference-check the articles.

I hope that once this site is up and running, I'll have time to write more articles to add to this collection.


"Understanding third-spacing" explains a concept that is very important for understanding some of the most deadly aspects of anaphylaxis. It's one thing to say that anaphylaxis can lead to circulatory collapse or pulmonary edema, but understanding the mechanics of how that happens requires familiarity with a few basic phsyiological terms.

"But is it anaphylaxis?" is an in-depth article that tries to answer the question I am most often asked: "How do I know if I'm having anaphylaxis?" This article is not aimed at people who've never had anaphylaxis, but rather to those people who have mast cell-related diseases (like idiopathic anaphylaxis, mastocytosis, severe allergies, or mast cell activation disorder). Some might think that the symptoms of anaphylaxis are dramatic and unmistakable, but those of us who experience frequent partial degranulation of mast cells are sometimes unsure just when we cross the line from miserable-but-not-life-threatening symptoms into full-blown anaphylaxis. Waiting too long to use an epinephrine auto-injector or to call for an ambulance can be the last bad decision someone will ever make, and I wrote this article to help patients navigate through the ins and outs of deciding when fast action is essential.

"Flushing? Don't sweat it!" explores the difference between flushing caused by cholinergic nerve stimulation and flushing caused by the release of mast cell mediators. Since someone with a mast cell-related disease can have both kinds of flushing (and more!) this article tries to help sort out the similarities and differences.

"Another marker for anaphylaxis?" introduces the wonderful world of carboxypeptidase A3 (CPA3), which is another neutral protease (in addition to tryptase) that mast cells release when they degranulate. Since people can have anaphylaxis — and even die of it! — without displaying elevated tryptase levels, CPA3 offers another potential way to assess a person having anaphylaxis.

"Histamine — Beyond mast cells" is a long article that tells you more than you may ever want to know about histamine. How much histamine is too much? Where does histamine come from? How do our bodies make histamine? What foods contain it? What is histamine intolerance and is it related to mast cell disease? Which foods can cause histamine release — or slow the breakdown of histamine? Should people with mast cell-related diseases avoid histamine-rich food? You'll find the answers in this article and its many tables that are chock-full of important information.

A New Kind of SAD? begins with research that suggests that there may be "non-winter" forms of Seasonal Affective Disorder (SAD) and then goes on to discuss the issue of sleep in relation to nasal allergies and depression in relation to mast-cell related diseases.

"Study finds allergy-like reaction may trigger rosacea" recounts a 2006 presentation by Dr. Richard Gallo that reported on then-new research into how substances call cathelicidins can be activated by kallikrein so that they then cause symptoms like those of rosacea.

"Probiotic drinks reduce antibiotic-induced diarrhea" is a brief article that discussed a 2007 study that found that probiotic yogurt drinks seemed to reduce the amount of diarrhea suffered by patients who were taking antibiotics. Given how prone many of us with mast cell-related diseases are to GI woes like diarrhea, I thought this research would be of interest.

Page last updated: January 18, 2012

All information contained in this site is one layperson's interpretation of medical journal articles, textbooks, seminars, presentations, and other materials. Nothing that is stated here should carry more weight than the informed and considered opinions of your own highly trained and qualified medical caregivers. The author of this site is not a doctor and has absolutely no authority to prescribe or diagnose.

The idiopathic anaphylaxis information center: A resource for people with IA and other mast cell disorders
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