{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T20:51:15Z","timestamp":1792875075994,"version":"4.5.0"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical &amp;amp; Translational All"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A variety of clinical signs and symptoms have been described in patients suspected of having mast cell activation syndrome (MCAS), however, symptom patterns and linked organ systems were not yet described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional online survey included adults with physician\u2010diagnosed self\u2010assessed or suspected MCAS between June and September 2021. Symptoms were collected as free\u2010text responses, and coded using the Medical Dictionary for Regulatory Activities (MedDRA). These data were then analyzed using an unsupervised machine learning approach to identify distinct participant clusters. Patient\u2010reported outcome measures (PROMs), including the PHQ\u20102, GAD\u20107, and SF\u201036, were used to assess mental health symptoms and health\u2010related quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 592 patients (mean age 45\u00a0years, 90% female) reported 400 symptoms in 58 categories. The hierarchical clustering algorithm failed to identify distinct patient clusters. We identified 256 (43%) patients with signs and symptoms aligning with the diagnostic criteria for MCAS including the most prevalent symptoms. Overall, patients infrequently reported mast cell\u2010mediated skin symptoms, such as pruritus (13%), wheals (9%), flushing (7%), or angioedema (1%). We identified patients with comorbid signs of depression (39%), general anxiety (34%), and impaired quality of life (28%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with suspicion of MCAS exhibit highly heterogeneous symptoms, whereas almost 50% report symptoms corresponding to the first diagnostic criterion for MCAS. Because over a third of the patients were tested positive for other diseases, we recommend considering common and more treatable diagnoses when evaluating patients with suspected MCAS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clt2.70184","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T02:04:54Z","timestamp":1783130694000},"source":"Crossref","is-referenced-by-count":1,"title":["A Real\u2010World Cross\u2010Sectional Study on Suspected Mast Cell Activation Syndrome: Multiple Heterogeneous Symptoms Identified"],"prefix":"10.1002","volume":"16","author":[{"given":"Annika","family":"Gutsche","sequence":"first","affiliation":[{"name":"Charit\u00e9 \u2013 University Medical Center Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin Institute of Allergology  Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9389-1767","authenticated-orcid":false,"given":"Thomas","family":"Buttgereit","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 University Medical Center Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin Institute of Allergology  Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00fcdiger","family":"Buchkremer","sequence":"additional","affiliation":[{"name":"Institute of IT Management and Digitization Research (IFID) FOM University of Applied Sciences in Economics and Management D\u00fcsseldorf  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6316-3112","authenticated-orcid":false,"given":"Jens","family":"Panse","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation University Hospital RWTH Aachen Center for Integrated Oncology Aachen, Bonn Cologne, Duesseldorf (CIO ABCD)  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6081-2858","authenticated-orcid":false,"given":"Nina","family":"Kreddig","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology and Medical Sociology Faculty of Medicine Ruhr University Bochum  Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Ptock","sequence":"additional","affiliation":[{"name":"Institute of IT Management and Digitization Research (IFID) FOM University of Applied Sciences in Economics and Management D\u00fcsseldorf  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Roll","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Institute for Biostatistics and Informatics in Medicine and Ageing Research Rostock University Medical Center  Rostock Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weronika","family":"Grabowska","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine, Epidemiology and Health Economics Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2105-6060","authenticated-orcid":false,"given":"Felix","family":"Aulenbacher","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 University Medical Center Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin Institute of Allergology  Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4070-9976","authenticated-orcid":false,"given":"Martin","family":"Metz","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 University Medical Center Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin Institute of Allergology  Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5520-2900","authenticated-orcid":false,"given":"Polina","family":"Pyatilova","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 University Medical Center Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin Institute of Allergology  Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4780-0772","authenticated-orcid":false,"given":"Pascale","family":"Salameh","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 University Medical Center Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin Institute of Allergology  Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology  Berlin Germany"},{"name":"School of Medicine Lebanese American University  Beirut Lebanon"},{"name":"Medical School University of Nicosia  Nicosia Cyprus"},{"name":"Institut National de Sant\u00e9 Publique, Epid\u00e9miologie Clinique et Toxicologie\u2013Liban (INSPECT\u2010LB)  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0162-0742","authenticated-orcid":false,"given":"Manuel P.","family":"Pereira","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 University Medical Center Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin Institute of Allergology  Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology  Berlin 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and Allergy (ASCIA) 2025 ASCIA Position Paper\u2014Diagnosis and Investigation of Mast Cell Activation Disorders and Syndrome\u2014Australasian Society of Clinical"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms222011270"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1359105315626784"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/13591053211014583"},{"key":"e_1_2_10_21_1","volume-title":"Experimental Dermatology","author":"Buttgereit T.","year":"2022"}],"container-title":["Clinical and Translational 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