Mast Cell Disorders Forum

Mast Cell Disorders Forum
http://mastcelldisorders.wallack.us/yabb/YaBB.pl General Mast Cell Disorders Discussion >> Mast Cell Disorder Doctors >> Roseville, CA - Dr. Theodor Feinstat http://mastcelldisorders.wallack.us/yabb/YaBB.pl?num=1393192063 Message started by Ladybug on 02/23/14 at 09:47:43

Title: Roseville, CA - Dr. Theodor Feinstat
Post by Ladybug on 02/23/14 at 09:47:43

He is familiar with mast cell, but new to MCAS. He was eager to receive all my handouts; said he would research this thoroughly, will ensure that correct stains are used on mast cell biopsies, and scheduled me to have an endoscopy and colonoscopy on the day when alternative meds can be used. He also called my allergist to discuss. He even has a great sense of humor! ;D

Dr. Theodor Feinstat
Capitol Gastroenterology Consultants Medical Group
4 Medical Plaza
Roseville, CA 95661
Ph: 916-773-6200
Web: www.capitolgi.com

Title: Re: Roseville, CA - Dr. Theodor Feinstat
Post by DeborahW, Founder on 02/23/14 at 10:20:15

Hi. What is the reason that you are having an endoscopy and colonoscopy? Is it to look for things other than mast cell disease? I ask because that is not normal testing when looking for mast cell disease. I have had both tests but that is when I had never even heard of mast cells and my doctors had no clue that mast cell disease even existed. So, they were just testing anything they could think of. Once I got to doctors who knew about mast cell disease, they focused on blood tests, my symptoms, my reactions to histamine blocker meds, and eventually a bone marrow biopsy. They never suggested endoscopy or colonoscopy testing.

Title: Re: Roseville, CA - Dr. Theodor Feinstat
Post by Ladybug on 02/23/14 at 11:03:51

Hi Deborah, I do have a few other health problems, which need examination. While he's checking those out, since I have MCAS, he will check out the mast cells. This is good as he may be able to shed more light, maybe notice something else or at least eliminate suspicions. You may have already read the articles: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3033552 and http://www.jhoonline.org/content/pdf/1756-8722-4-10.pdf (page 4) and http://tmsforacure.org/documents/MastocytosisExplained.pdf (page 2)

I'm curious about the bone marrow testing, which scares me and I hope I never have to have one. Aren't those supposed to a hit or miss? That not all bone marrow will reflect mast cell disease and that a bone marrow test could miss that area by inches and come up negative? How does a specialist know which area to extract from? Thanks!

Title: Re: Roseville, CA - Dr. Theodor Feinstat
Post by Joan on 02/23/14 at 12:09:50

There are specific places from which doctors extract bone marrow, the most common for diagnosing mast cells would be on the iliac crest, the hip bone in the back. I'm not sure why, but that's the usual place. Yes, they can go into a spot that doesn't have a lot of mast cells if they aren't spread throughout a bone. Conversely, they can aspirate clusters of mast cells which are not typical of their presence in other places in the bones.

So, a bone marrow biopsy is one factor considered when making a diagnosis. Obviously, if there's a finding of abnormal mast cells and/or an abnormal number and/or clusters of mast cells, it might verify the suspicion of mast cell disease. Other factors and test results will be included in a diagnosis, such as tryptase and other things tested in the blood. There are several diseases that need to be ruled out, too.

Good luck! I hope all goes well with testing and you get some answers.

Title: Re: Roseville, CA - Dr. Theodor Feinstat
Post by Ladybug on 02/23/14 at 12:45:49

Oh dear, Joan. This makes me cringe. From your experience, when someone is diagnosed with MCAS, do doctors leave it at that? What might cause them to have further testing to check for Mastocytosis? If treatments are the same, does it even matter to further define between the two? Thank you!

Joan wrote on 02/23/14 at 12:09:50:

Title: Re: Roseville, CA - Dr. Theodor Feinstat
Post by JT on 11/02/15 at 03:24:53

Hi, I got a bone marrow bx a month ago. I asked my doctor why it is taking so long for the results. She finally called the pathologist after still showing "pending" and on my prompting. She says there are no mast cells in my bone marrow?? But my tryptase is 32. She has ruled out cutaneous an SM. I suggested could it be isolated in the stomach since I initially responded to H2 blockers? I suggested a biopsy of my stomach mucosa to diagnose. I may have MSAS.

Title: Re: Roseville, CA - Dr. Theodor Feinstat
Post by Joan on 11/08/15 at 18:27:32

You could have Mastocytic Enterocolitis, which is diagnosed by biopsy during a colonoscopy or a mast cell activation disorder (MCAS). Has your doctor ruled out other diseases that can have similar symptoms, such as carcinoid syndrome and pheochromocytoma? I would consider getting another opinion from a mast cell disorder expert/researcher.