Possible mast cell activation syndrome in a patient undergoing long-term hemodialysis

Mast cell activation syndrome (MCAS) is the clinical presentation of acute episodes of mast cell mediator–induced symptoms without an elevation in the number of mast cells in the tissues or elevations of tryptase greater than 20 ng/mL.1 Serum tryptase is a biomarker of mast cell activation and is seen in MCAS.2 Serum tryptase in patients undergoing hemodialysis is elevated to above the 95th percentile and correlated with the severity of pruritus.3 We present a case of possible MCAS due to long-term hemodialysis.

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