peter
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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)
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