Journal Mobile

S Pearce, I Talapatra
Journal Issue: 
Volume 38: Issue 1: 2008




A  59-year-old  man  was  referred  to  the  authors’  medical  clinic  with  a history  of  four  episodes  of  collapse  over  five  years. The  patient  had  a  history  of urticaria  pigmentosa  diagnosed  12  months  previously. The  recognition  of  his  skin condition and the history of recurrent, albeit infrequent, collapses accompanied by hypotension  and  pruritis  led  to  the  suspicion  of  mastocytosis. He  had  persistent elevation of serum tryptase consistent with mast cell disease, but the analysis of a bone marrow biopsy failed to confirm systemic disease. Mastocytosis can lead to numerous symptoms directly related to the degranulation of mast cells by certain physical  and  pharmacological  stimuli, and  can  present  with  recurrent  anaphylactic attacks. Provision of an EpiPen can be life-saving in affected individuals. The association of urticaria pigmentosa and mastocytosis is of vital importance to physicians who are frequently faced by patients presenting with collapse without cause.