Systemic mastocytosis presenting as occupational IgE-mediated anaphylaxis to pine processionary caterpillar

Mastocytosis is characterized by the accumulation of clonal mast cells (MCs) in organs such as skin, bone marrow (BM), and the gastrointestinal tract. Patients with systemic mastocytosis often have symptoms related to the mediator release of MCs, including anaphylaxis in 22% to 49% of the cases.1,2 The frequency of anaphylaxis among patients with indolent systemic mastocytosis without skin lesions (ISMs−) is higher than that found in patients with skin involvement (ISMs+).2–4

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