Mimics of Allergy and Angioedema: Scombroid, Mast Cell Activation Disorders, and Hereditary Alpha Tryptasemia

Immunol Allergy Clin North Am. 2023 Aug;43(3):553-568. doi: 10.1016/j.iac.2022.10.007.

Abstract

Scombroid poisoning, systemic mastocytosis, and hereditary alpha tryptasemia all present with episodes that resemble allergic reactions. Knowledge regarding systemic mastocytosis and hereditary alpha tryptasemia is quickly evolving. Epidemiology, pathophysiology, and strategies to identify and diagnose are discussed. Evidence-based management in the emergency setting and beyond is also explored and summarized. Key differences are described between these events and allergic reactions.

Keywords: Anaphylaxis; Hereditary alpha tryptasemia; Histamine; Mast cells; Mastocytosis; Scombroid; Tryptase.

Publication types

  • Review

MeSH terms

  • Anaphylaxis* / diagnosis
  • Angioedema* / diagnosis
  • Angioedema* / epidemiology
  • Angioedema* / etiology
  • Humans
  • Mast Cell Activation Disorders*
  • Mast Cells / physiology
  • Mastocytosis* / diagnosis
  • Mastocytosis* / genetics
  • Mastocytosis, Systemic* / diagnosis
  • Mastocytosis, Systemic* / genetics
  • Tryptases / genetics

Substances

  • Tryptases