Comprehensive Mast Cell Disorder Management
Mast Cell Disorder Specialist in New Orleans
Dr. Reena Mehta is a board-certified allergist / immunologist that specializes in mast cell disorders in New Orleans, LA. Dr. Mehta can help you thrive over mast cell disorders like mastocytosis and mast cell activation syndrome (MCAS).
“Dr. Reena Mehta is a world-class physician. She is prompt, thorough, kind, patient, diligent, professional and brilliant. Yet, what amazes me the most is her devotion and resourcefulness as she tirelessly journeys through my complex medical history while facilitating my current special needs as a patient with a mast cell disorder. She is the answer to my prayers for a local, eager, tenacious, and receptive mast cell specialist.“
– Lea F, June 2019
Mast cells are immune cells throughout the body that produce allergic response mediators when activated. One such mediator is histamine. In a healthy individual, mast cells are activated to defend against harmful bacteria, parasites, fungi, viruses, and and other pathogenic substances.
Broadly speaking, mast cell disorders describe conditions that are related to the overreaction or inappropriate activation of mast cells, causing symptoms similar to a severe allergic reaction. Mast cell disorders can occur in both children and adults.
Mastocytosis occurs when mast cells are present in greatly increased numbers and, as a consequence, release an excessive amount of allergic response mediators when activated by dietary or environmental triggers.
Mast Cell Activation Syndrome (MCAS)
Mast cell activation syndrome describes the inappropriate activation of mast cells with little or no observed increase in the number of mast cells throughout the body. Inappropriate triggers can include different foods, chemicals, fragrances, exercise, or stress. MCAS is not caused by an allergy nor is it secondary to other conditions that are known to activate normal mast cells.
Mast Cell Disorders, Hypermobile Ehlers-Danlos Syndrome, and Postural Orthostatic Tachycardia Syndrome
Recent research has revealed a possible new disease cluster involving mast cell activation disorders, postural orthostatic tachycardia syndrome (POTS), and Hypermobile Ehlers-Danlos syndrome (hEDS).
Hypermobile Ehlers-Danlos Syndrome (hEDS) is a rare inherited condition that affects connective tissue, resulting in very flexible joints and stretchy skin that breaks easily. This connective tissue disease can also affect other systems in the body including the digestive tract (heartburn, constipation), the heart (mitral valve prolapse), the bladder (stress incontinence), and other organs (organ prolapse).
Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that causes an abnormal increase in heart rate after sitting up or standing. Patients with POTS often tend to describe discomfort when their heart rate increases, and can also experience lightheadedness and fainting. Symptoms are usually alleviated by sitting or lying back down.
In a study published in 2015, patients having a diagnosis of POTS and EDS were given a screening questionnaire to look for symptoms consistent with MCAS, and 66% of the respondents reported such symptoms. While much about these conditions and the nature of the relationships between them remain unknown, many researchers and medical professionals are now looking at these conditions together as a unique syndrome that’s relatively common in individuals with mast cell disorders.
Mastocytosis can appear as distinct “spots” that look like freckles. These spots are called urticaria pigmentosa, and they can transform into hives and itch if stroked or irritated, or if the skin is exposed to sudden changes in temperature such as a hot shower.
Other symptoms of mastocytosis include:
- Anaphylaxis (severe allergic reaction)
- Shortness of breath
- Low blood pressure
- Hives and swelling
- Nausea and vomiting
- Uterine cramps / bleeding
- Musculoskeletal pain
An individual with MCAS often experiences repeated episodes of anaphylaxis that can affect different organ systems in the body. These include:
- Heart related symptoms: rapid pulse, low blood pressure, passing out
- Skin related symptoms: itching, hives, swelling, red skin
- Lung related symptoms: throat swelling, wheezing, shortness of breath, harsh noise when breathing
- Gastrointestinal tract symptoms: diarrhea, nausea with vomiting, crampy abdominal pain
If you suspect that you have a mast cell disorder, it’s important to seek care from an allergist / immunologist that is a mast cell disorder specialist. Diagnosis of mastocytosis can include:
- Blood counts
- Measurement of mast cell mediators in blood and urine
- Skin and bone marrow biopsies
- Liver function studies
- Genetic tests
- Cromolyn sodium
- Leukotriene-modifying agents
- Certain antihistamine medications (type 1 receptor blockers) can be effective for itching, abdominal discomfort, and flushing, while others (type 2 receptor blockers) can help with abdominal pain and nausea
- Aspirin can reduce flushing
- Montelukast and zafirlukast can help reduce wheezing and abdominal cramping
- Corticosteroids can be helpful for edema, hives, and wheezing
- Omalizumab may help reduce anaphylactic episodes
If these treatments are ineffective, it’s unlikely that you have MCAS.
See a Mast Cell Disorder Specialist in New Orleans
If you suspect that you or your child are living with a mast cell disorder, it might be time to see a mast cell disorder specialist. Dr. Mehta has a reputation for developing strong relationships with her patients and being exceptionally attentive to their needs and concerns.
Call us anytime, M-F, 8am-5pm.
Saturday appointments available upon request.
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