Petra, Anastasia I, Panagiotidou, Smaro, Stewart, Julia M et al. · Expert review of clinical immunology · 2014 · DOI
Mast cells are immune cells that can become overactive and release chemicals causing symptoms like flushing, itching, dizziness, stomach problems, headaches, and brain fog. This review describes different types of mast cell activation disorders and explains how they can overlap with conditions like ME/CFS and fibromyalgia. The authors suggest these conditions exist on a spectrum and outline how doctors can test for and treat them.
ME/CFS patients frequently experience symptoms overlapping with mast cell activation disorders (fatigue, cognitive dysfunction, orthostatic intolerance, gastrointestinal issues), and this review identifies mast cell dysfunction as a potential shared biological mechanism. Understanding this spectrum could help clinicians recognize and properly diagnose comorbid mast cell disorders in ME/CFS patients and guide targeted treatment approaches.
This review does not establish causal relationships between mast cell activation and ME/CFS, nor does it provide epidemiological data on the prevalence of MCAS in ME/CFS populations. It cannot definitively separate which symptoms are primary to mast cell disorders versus secondary or coincidental with ME/CFS, as it synthesizes existing literature rather than presenting new primary data.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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Primary citation
Petra, Anastasia I, Panagiotidou, Smaro, Stewart, Julia M, Conti, Pio, & Theoharides, Theoharis C (2014). Spectrum of mast cell activation disorders.. Expert review of clinical immunology. https://doi.org/10.1586/1744666X.2014.906302
BibTeX
@article{mecfsatlas-petra-2014-spectrum-mast,
author = {Petra, Anastasia I and Panagiotidou, Smaro and Stewart, Julia M and Conti, Pio and Theoharides, Theoharis C},
title = {Spectrum of mast cell activation disorders.},
journal = {Expert review of clinical immunology},
year = {2014},
doi = {10.1586/1744666X.2014.906302},
note = {PubMed: 24784142},
url = {https://www.mecfsatlas.com/evidence/petra-2014-spectrum-mast},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/petra-2014-spectrum-mast
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