A Clinical Yardstick for Managing Mast Cell Activation Syndrome (MCAS)
Welcome to the Allergy, Asthma & Immunology Innovations podcast. It’s another episode of The Itch Review, where we highlight recent research in allergy and immunology. This episode looks at recommendations for diagnosing and treating mast cell activation syndrome (MCAS).
Our hosts, Payel Gupta, MD, and Kortney, are joined by Michael Blaiss, MD, to review the MCAS article, “Management of indolent mastocytosis and mast cell activation syndrome – A clinical yardstick,” published June 2025 in the Annals of Allergy, Asthma & Immunology.
This is the first of two podcast episodes focusing on this study and mast cell activation syndrome.
The podcast evaluates a new yardstick for mast cell diseases. A yardstick gives doctors practical guidance on how to care for patients while waiting for complete medical guidelines. It recommends how doctors should diagnose and treat MCAS.
You can listen to the podcast on ItchPodcast.com or download it for listening anytime, anywhere, at:
This podcast is for informational purposes only and does not substitute professional medical advice. Any mention of brands is also informational and not an endorsement. Always consult with your healthcare provider for any medical questions or concerns.
Thanks to Blueprint Medicines for sponsoring this episode.
What is mast cell activation syndrome?
Mast cells are special cells in your immune system. They store chemicals such as histamine and release them when your body reacts to something. In MCAS, mast cells release excessive amounts of chemicals too often, even when they should not.
A lot of MCAS symptoms look like other diseases. This makes it hard to diagnose and treat. This podcast episode looks at the new yardstick recommendations for diagnosing and treating MCAS.
What we cover in this podcast on MCAS
- What a yardstick is and why doctors use it.
- How mast cell disorders are classified (clonal, secondary, and idiopathic).
- Diagnosis criteria: symptoms in more than one body system, test results, and responses to medicine.
- Treatment options: antihistamines, leukotriene blockers, cromolyn, aspirin, omalizumab and epinephrine.
- Why brain fog, anxiety and depression are common and require multidisciplinary management.
Timestamps for podcast on diagnosing and treating MCAS
01:21 – What is a yardstick and how doctors use it
02:59 – The 3 classifications of mast cell disorders
06:28 – How MCAS is diagnosed
08:15 – Step 1: Symptoms in two or more body system
10:25 – Step 2: Tryptase test: blood and urine tests
15:05 – Step 3: Feeling better with medicine
16:38 – Why diagnosis is tricky
20:11 – Avoiding triggers that set off symptoms
21:56 – Using antihistamines for MCAS
25:29 – Leukotriene blockers
26:24 – Cromolyn and aspirin to calm mast cells
28:16 – Treating brain fog, anxiety, and depression
29:31 – When patients need epinephrine
32:51 – What omalizumab might help with
35:29 – Doctor takeaways and final thoughts
Resources about mast cell disease
- Mast Cell Disease Toolkit
- What is Mastocytosis? Types, Symptoms, and Treatment
- Mast Cell Disease Glossary of Terms
Other podcast episodes about mast cell diseases
