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Abstract：
Mast cell activation syndrome (MCAS) is an immune disease with an estimated prevalence of 17%. Mast cell chemical mediators lead to heterogeneous multisystemic inflammatory and allergic manifestations. This syndrome is associated with various neurologic and psychiatric disorders, including headache, dysautonomia, depression, generalized anxiety disorder, and many others. Although MCAS is common, it is rarely recognized, and thus, patients can suffer for decades. The syndrome is caused by aberrant mast cell reactivity due to the mutation of the controller gene. A case series is presented herein including eight patients with significant neuropsychiatric disorders that were often refractory to standard medical therapeutics. Five patients had depression, five had generalized anxiety disorder, and four had panic disorder. Other psychiatric disorders included attention-deficit hyperactivity disorder, obsessive compulsive disorder, phobias, and bipolar disorder. All eight patients were subsequently diagnosed with mast cell activation syndrome; six had comorbid autonomic disorders, the most common being postural orthostatic tachycardia syndrome; and four had hypermobile Ehlers-Danlos syndrome. All patients experienced significant improvements regarding neuropsychiatric and multisystemic symptoms after mast-cell-directed therapy. In neuropsychiatric patients who have systemic symptoms and syndromes, it is important to consider the presence of an underlying or comorbid MCAS.
摘要：
肥大细胞活化综合征（MCAS）是一种免疫性疾病，估计患病率为17％。肥大细胞化学介质导致异质性多系统炎症和过敏性表现。这种综合征与各种神经和精神疾病有关，包括头痛,自主神经失调,抑郁症,广泛性焦虑障碍,和许多其他人。虽然MCAS很常见,它很少被识别，因此，病人可以忍受几十年。该综合征是由控制基因的突变引起的肥大细胞反应异常引起的。本文提供了一系列病例，包括八名患有严重神经精神疾病的患者，这些患者通常对标准医学疗法难以治疗。五个病人有抑郁症,五个人患有广泛性焦虑症，四个人患有恐慌症。其他精神疾病包括注意力缺陷多动障碍，强迫症,恐惧症,和双相情感障碍。所有8名患者随后被诊断为肥大细胞活化综合征；6名患有共病自主神经紊乱，最常见的是体位性心动过速综合征;4例患有高流动性Ehlers-Danlos综合征。肥大细胞指导治疗后，所有患者的神经精神症状和多系统症状均有显着改善。在有全身症状和综合征的神经精神病患者中，重要的是要考虑潜在或合并症MCAS的存在。
