Factors that can evoke the release of MC mediators in patients with mastocytosis  
– Heat (frequent): use mildly warm water for bath or shower. Do not rub briskly with towel to dry off. When drying hair, use hair dryer only on warm heat
– Cold (frequent)
– Pressure (frequent): traumas to scalp in patients with skin lesions in this area. Avoid Darier’s sign (friction of skin lesions), this procedure can evoke a massive mast cell mediators release, specially in large lesions (mastocytomas)
– Exercise (rare)
– Endoscopies (exceptional): panendoscopy, rectoscopy, colonscopy
– Manipulation of GI system/intestines during surgery (exceptional)
Emotional factors
– Stress (frequent)
– Anxiety (frequent)
Drugs and medication
– NSAIDs* (frequent) such as aspirin (acetylsalicylic acid), mefanamic acid, butibufen, diclofenac, fenbufen, fenilbutazone, flurbiprofen, ibuprofen, indometacine, ketoprofen, ketorolac, meclofenamate, metamizole, nabumetone, naproxen, propifenazone, among other drugs
– Opioids and morphine derivatives (rare) such as morphine, codeine, buprenorphine, meperidine, dextromethorphan, dimemorphan, fentanyl, tramadol, among other drugs
– Alcohol† (rare)
– Muscle relaxants and inductors used in general anesthesia∫ (rare)
– Local anesthetics‡ (exceptional if amide-derivatives are used)
– Contrast media (rare)
– Interferon-alpha 2b§ (exceptional)
– Clorodeoxiadenosine (2-Cda)¶ (exceptional)
– Hydroxyurea** (exceptional)
– Colloids (rare)
Insects
– Hymenoptera sting (frequent, particularly in ISMs-)
– Red ant (exceptional in Europe)
Hormonal changes
– Pregnancy (frequent)††
– Menstruation (frequent)
Miscellaneous
– Infections or fever of any etiology (frequent, particularly in children)
– Teething in children (frequent)
– Vaccination (rare, except in children with DCM)