Cutaneous mastocytosis and allergic diseases in children: a cross-sectional study

Abstract

BACKGROUND: Mastocytosis is a heterogeneous group of diseases with abnormal accumulation of clonal mast cells in one or more organs. Comorbidities in patients with mastocytosis include IgE-dependent allergies, psychiatric or psychological disorders, and vitamin D deficiency. Despite the clinical similarities between allergies and mastocytosis, only a few European studies have considered comorbidities. AIMS:to analyze the frequency of concomitant allergic diseases in children with cutaneous mastocytosis. MATERIALS AND METHODS:We analyzed the data of 248 children aged 6 months to 17 years inclusive with a diagnosis of cutaneous mastocytosis, who were on outpatient treatment and observation at the Moscow Scientific and Practical Center for Dermatovenereology and Cosmetology from January 2019 to June 2023. Serum levels of total IgE and allergen-specific IgE were analyzed in children with and without allergic diseases. In addition, a positive history of allergy was analyzed in close relatives of children with CM. RESULTS:It was revealed that every third child (36.7%) with cutaneous mastocytosis had a concomitant allergic disease. In 27.4% of the examined children, allergic diseases were in relatives. In children with mastocytomas, the process was significantly more often accompanied by the development of allergic diseases than in children with maculopapular cutaneous mastocytosis (2=45.46, p=0.001). The level of total IgE was not a statistically significant sign of the presence of allergic diseases in mastocytosis (2 =1.161, p=0.3). Allergen-specific IgE were detected in 47.2% of children with allergic diseases. Among children without manifestations of food allergy and pollinosis, asymptomatic low and moderate sensitization to any plant product and birch was detected in 26.5%. Sensitization only to respiratory allergens was found in 8% of children with cutaneous mastocytosis without allergic diseases. CONCLUSIONS: In Russia, this study for the first time demonstrated a high incidence of allergic diseases in children with cutaneous mastocytosis. The results of the study showed that all clinical forms of mastocytosis in children, including cutaneous mastocytomas, should be subject to interdisciplinary observation and examination. Timely detection of comorbid allergic diseases contributes to the development of individual tactics for the treatment and prevention of complications and anaphylaxis.