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Table 1 Effects of mast cell mediators in mastocytosis

From: Critical care management of systemic mastocytosis: when every wasp is a killer bee

Mediator(s)

Features

Cardiovascular

Prostaglandins

Flushing (increased heart rate and increased cardiac output)

Protease (Chymase)

Increased blood pressure

Histamine

Increased vasopermeability

Histamine, prostaglandin D2, leukotrienes, and platelet-activating factor

Vasodilatation and hypotension

Platelet-activating factor

Arrhythmia

Cutaneous

Histamine, prostaglandin D2, and platelet-activating factor

Urticaria with or without angioedema

Histamine

Pruritus

Respiratory

Histamine, leukotrienes, prostaglandin D2, and platelet-activating factor

Bronchusconstriction

Prostaglandin D2 and leukotrienes

Increased mucus production

Platelet-activating factor and leukotrienes

Pulmonary oedema

Histamine

Rhinitis

Gastrointestinal

Histamine

Increased gastric acid secretion

Histamine

Diarrhoea

Platelet-activating factor

Abdominal ache

Hematologic

Heparin and proteases

Coagulation disturbances

Remainder

Histamine

Headache

Heparin, interleukin-6 (IL-6), and tryptase

Osteopenia and osteoporosis

Pro-inflammatory cytokines (for example, tumour necrosis factor-alpha) and chemokines

Fatigue, weight loss, local inflammation, oedema formation, and leukocyte migration

Growth factor (IL-6)

Fever

Tryptase

Endothelial activation with consecutive inflammatory reactions