What is our Clinical Approach? (criteria required)
Mast Cell Activation Syndrome (MCAS) is a complex condition that can affect multiple systems throughout the body, often causing symptoms that are difficult to explain or diagnose. The physicians at Carolina Asthma and Allergy Center evaluate MCAS based on current evidence and practice guidelines.
To summarize our approach, we consider a diagnosis of MCAS when all three consensus criteria are met:
- Multi-System Symptoms: Recurrent, episodic symptoms of systemic mast cell activation involving two or more organ systems at the same time, such as skin and cardiovascular.
- Elevated Mast Cell Mediators: Documented elevation in serum tryptase, either above 11.4 ng/mL at baseline, or a rise to 1.2x baseline plus 2 ng/mL during an acute episode.
- Response to Treatment: Clinical improvement with directed therapy, such as H1 and H2 antihistamines, supporting mast cell activation as the underlying driver.
Requesting an Appointment (criteria required)
Carolina Asthma & Allergy Center evaluates patients for Mast Cell Activation Syndrome only when there is documented evidence that all three consensus criteria listed above are met.
Before requesting an appointment, please confirm that your medical records include:
- Recurrent symptoms involving two or more organ systems at the same time;
- Qualifying serum tryptase results, including the applicable baseline and acute-episode laboratory results; and
- Documented improvement with mast cell–directed treatment.
If your records do not demonstrate all three criteria, including the required laboratory findings, please continue working with your current healthcare provider. An appointment for an MCAS evaluation should not be requested at this time.
If all three criteria are documented, you may submit the appointment request form along with the supporting medical records and laboratory results. Submission of a request does not guarantee an appointment; records will be reviewed before scheduling.
What if my records don't yet show all three required criteria?
If your current medical records don't demonstrate all three consensus criteria, including the required lab findings, we recommend continuing to work with your current healthcare provider to gather this documentation first. An appointment shouldn't be requested until all three criteria are met and documented, as submitted requests are reviewed against these criteria before scheduling.