{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T02:09:16Z","timestamp":1785722956789,"version":"3.56.0"},"reference-count":103,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T00:00:00Z","timestamp":1704412800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Mastocytosis is a myeloproliferative neoplasm characterized by abnormal proliferation and activation of clonal mast cells typically bearing the KITD816V mutation. Symptoms manifest due to the release of bioactive mediators and the tissue infiltration by neoplastic mast cells. Mast cell activation symptoms include flushing, pruritus, urticaria, abdominal cramping, diarrhea, wheezing, neuropsychiatric symptoms, and anaphylaxis. Up to 50% of patients with mastocytosis report a history of provoked and unprovoked anaphylaxis, with Hymenoptera venom and drugs the most common culprits. NSAIDs, antibiotics, vaccines, perioperative medications, and radiocontrast media are often empirically avoided without evidence of reactions, depriving patients of needed medications and placing them at risk for unfavorable outcomes. The purpose of this review is to highlight the most common agents responsible for adverse drug reactions in patients with mastocytosis, with a review of current epidemiology, diagnosis, and management of drug hypersensitivity and Hymenoptera venom allergy.<\/jats:p>","DOI":"10.3390\/diagnostics14020123","type":"journal-article","created":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T03:43:00Z","timestamp":1704426180000},"page":"123","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Challenges in Drug and Hymenoptera Venom Hypersensitivity Diagnosis and Management in Mastocytosis"],"prefix":"10.3390","volume":"14","author":[{"given":"Matthew P.","family":"Giannetti","sequence":"first","affiliation":[{"name":"Division of Allergy and Clinical Immunology, Brigham and Women\u2019s Hospital, Boston, MA 02115, USA"},{"name":"Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Nicoloro-SantaBarbara","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, MA 02115, USA"},{"name":"Department of Psychiatry, Brigham and Women\u2019s Hospital, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Godwin","sequence":"additional","affiliation":[{"name":"Division of Allergy and Clinical Immunology, Brigham and Women\u2019s Hospital, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Middlesworth","sequence":"additional","affiliation":[{"name":"Division of Allergy and Clinical Immunology, Brigham and Women\u2019s Hospital, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Espeland","sequence":"additional","affiliation":[{"name":"Division of Allergy and Clinical Immunology, Brigham and Women\u2019s Hospital, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia L.","family":"Douvas","sequence":"additional","affiliation":[{"name":"Division of Allergy and Clinical Immunology, Brigham and Women\u2019s Hospital, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana C.","family":"Castells","sequence":"additional","affiliation":[{"name":"Division of Allergy and Clinical Immunology, Brigham and Women\u2019s Hospital, Boston, MA 02115, USA"},{"name":"Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1016\/j.jaip.2022.05.007","article-title":"Global Classification of Mast Cell Activation Disorders: An ICD-10-CM\u2013Adjusted Proposal of the ECNM-AIM Consortium","volume":"10","author":"Valent","year":"2022","journal-title":"J. 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