{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T14:22:53Z","timestamp":1747146173989,"version":"3.40.5"},"reference-count":13,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T00:00:00Z","timestamp":1589414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Mast\u2010cell activation syndrome (MCAS) is increasingly recognized. Sinonasal obstruction is common among these patients. There is a paucity of literature describing the characteristics of MCAS and treatment outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review of 192 patients with nasal congestion July 2017 to May 2019 among 3 providers (1 allergist, 2 rhinologists) was conducted. Suspected MCAS criteria were as follows: (1) at least 2 recurrent severe symptoms in addition to nasal congestion: flushing, pruritus, urticaria, angioedema, wheezing, throat swelling, headache, hypotension, diarrhea; (2) clinical response to medications that target mast cell mediators. Quality of life (QOL) outcomes were quantified using the 22\u2010item Sino\u2010Nasal Outcome Test (SNOT\u201022).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010two patients with nasal congestion were suspected of MCAS. The median age was 47 years; 24 of 32 were female; 13 of 32 had prior history of sinonasal surgery and 11 of 32 allergen immunotherapy. Out of 32, 19 had history of asthma, 10 drug allergy, 11 food allergy, and 10 anaphylaxis. The median number of medications targeting mast cell activation was 4 (range, 2\u20107). Eleven patients were offered surgery by a rhinologist after adequate medical management. Three of 32 patients showed elevation of serum tryptase. Fourteen completed pretreatment and posttreatment SNOT\u201022 (4\/14 surgery, 10\/14 medical management). Pretreatment score was 59.8 \u00b1 6.2 (mean \u00b1 standard error [SEM]) and posttreatment score was 42.8 \u00b1 6.7; the difference was statistically and clinically significant (<jats:italic>p<\/jats:italic> = 0.0015). Both groups showed a mean 17\u2010point reduction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A multidisciplinary approach to the treatment of sinonasal symptoms using both escalation of medical therapy and surgical approaches may improve QOL of patients with suspected MCAS. Consensus criteria for MCAS, which includes elevation in tryptase over baseline during an episode, may exclude the full spectrum of individuals with MCAS from potentially beneficial treatment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.22558","type":"journal-article","created":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T22:24:35Z","timestamp":1589495075000},"page":"996-1000","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Patient characteristics of suspected mast\u2010cell activation syndrome with sinonasal obstruction: a single institution experience"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7841-7293","authenticated-orcid":false,"given":"Jee\u2010Hong","family":"Kim","sequence":"first","affiliation":[{"name":"Rick and Tina Caruso Department of Otolaryngology\u2013Head and Neck Surgery Keck School of Medicine of University of Southern California  Los Angeles CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shijun","family":"Xi","sequence":"additional","affiliation":[{"name":"Allergy and Immunology, Department of Medicine Keck School of Medicine of University of Southern California  Los Angeles CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4177-6716","authenticated-orcid":false,"given":"Elisabeth H.","family":"Ference","sequence":"additional","affiliation":[{"name":"Rick and Tina Caruso Department of Otolaryngology\u2013Head and Neck Surgery Keck School of Medicine of University of Southern California  Los Angeles CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marshall","family":"Ge","sequence":"additional","affiliation":[{"name":"Rick and Tina Caruso Department of Otolaryngology\u2013Head and Neck Surgery Keck School of Medicine of University of Southern California  Los Angeles CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona M.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Immunology, Allergy, and Rheumatology University of California, Los Angeles  Los Angeles CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bozena B.","family":"Wrobel","sequence":"additional","affiliation":[{"name":"Rick and Tina Caruso Department of Otolaryngology\u2013Head and Neck Surgery Keck School of Medicine of University of Southern California  Los Angeles CA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,5,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2010.08.035"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000328760"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2019.08.023"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1756-8722-4-10"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjms.2016.12.013"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2019.01.006"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2009.01995.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27008"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21721"},{"journal-title":"Ear Nose Throat J","article-title":"Treatment outcomes in chronic rhinosinusitis refractory to maximal medical therapy: a prospective observational study under real\u2010world conditions","author":"Dejaco D","key":"e_1_2_6_11_1"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1385\/CRIAI:29:2:151"},{"issue":"1","key":"e_1_2_6_13_1","first-page":"5","article-title":"Mast cell disorders\u2010experience of a tertiary referral centre","volume":"181","author":"Wharin S","year":"2018","journal-title":"Br J Haematol"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.12053"}],"container-title":["International Forum of Allergy &amp; 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