Arch Mal Coeur Vaiss. 1993 Dec;86(12):1747-52.
[A rare cause of loss of consciousness: mastocytosis. Apropos of 3 cases].

[Article in French]

Dacosta A, Guy JM, Cathebras P, Perrot JL, Decousus H, Tardy B, Gonthier R, Lamaud M, Rousset H, Verneyre H.

Service de cardiologie, Hôpital Nord, Saint-Priest-en-Jarez.
Abstract

The authors report three cases of syncope due to systemic mastocytosis. This is a rare cause of syncope but should be recalled in certain circumstances. In the light of these cases, the authors review the literature with respect to this unusual presentation. Syncope may occur at any age. Loss of consciousness may be more or less complete, brief or prolonged, isolated or recurrent and usually accompanied by prodromal symptoms. The least controversial physiopathogenic mechanism of these syncopes is intense vasoplegia induced by the release of vasoactive mediators, especially histamine. When there is a clinical suspicion of mastocytosis, even in the absence of skin changes, the diagnosis is confirmed by biopsy which shows abnormally high numbers of mastocytes irrespective of the organ biopsied. The treatment of acute forms with collapse is based on intravenous infusion of macromolecular fluids and injections of epinephrine. Prevention is by drugs which inhibit the synthesis of histamine, the degranulation of mastocytes and the production of prostaglandin D2.

PMID: 8024376 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/8024376

Mona, Dear, you've found my case!!!


This is what I go through.  This is the very reaction which forced me to study so hard in order to find my answers!   This is the prolonged syncope reaction.  It's caused by intense vasoplegia which is a reaction created by the inflammatory mediators due to the mast cells.   This is what my doctors saw me going through for hours on end which they could not understand since it's such an unusual kind of reaction.

This article was performed by cardiologists and not neurologists and they don't yet understand all of the neurological issues involved here.  This is a very, very rare reaction amongst masto patients and it can cause us to be semi-conscious or totally unconscious.  We can be out for as little as 15 minutes or much, much longer.  I spoke with one patient who was seen out for 8 hours following surgery.  I've been out as long as 6 following contrast injection!  

I wish I could get someone to study my reaction further for I want more ANSWERS!!

Now, how to deal with it, is also an issue and my doctors haven't learned this one yet!

Oh well!