The Itch: Allergies, Asthma, Eczema & Immunology

#127 - Management of indolent mastocytosis - A clinical yardstick


Listen Later

Indolent Systemic Mastocytosis (ISM) is a rare but often underrecognized clonal mast cell disorder. From random hives to gut pain and brain fog, ISM can feel like a medical mystery.

We continue our review of “Management of indolent mastocytosis and mast cell activation syndrome - A clinical yardstick,” published in June 2025 in The Annals of Allergy, Asthma & Immunology. This is Part 2 of our discussion, with a focus on indolent systemic mastocytosis. We look at what causes it, how it’s diagnosed, and how to manage symptoms and improve quality of life.

In this episode, we break down this complex mast cell disease and how doctors use baseline serum tryptase, KIT D816V testing, and HaT screening to find answers. Plus, we explain how treatments like antihistamines, mast cell stabilizers, and avapritinib can help people live better with ISM.

📌 INFOGRAPHIC to follow along

What we cover in our episode about indolent systemic mastocytosis (ISM):
  • Yardsticks explained: Why the ACAAI uses yardsticks as practical, interim guidelines before full consensus statements are available.
  • Understanding mast cell diseases: The difference between primary (clonal), secondary (allergic), and idiopathic mast cell disorders.
  • Diagnosing ISM: KIT D816V mutation, WHO/ICC criteria, baseline serum tryptase, and when to test for hereditary alpha-tryptasemia (HaT).
  • Symptoms of ISM: Why symptoms vary and how they can involve multiple systems, including skin, GI tract, cardiovascular, and even neuropsychiatric.
  • Management strategies: Trigger avoidance, antihistamines, leukotriene blockers, sodium cromolyn, aspirin therapy, and, when venom immunotherapy is appropriate.
  • Targeted treatment: How avapritinib works and what the PIONEER study shows about its role in ISM.
  • The Itch Review, hosted by Dr. Gupta, Kortney, and Dr. Blaiss, explores allergy and immunology studies, breaking down complex research in conversations accessible to clinicians, patients, and caregivers. Each episode provides key insights from journal articles and includes a one-page infographic in the show notes for easy reference.

    ___

    Made in partnership with The Allergy & Asthma Network.

    Thanks to Blueprint Medicines for sponsoring today’s episode. 

    This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

    ...more
    View all episodesView all episodes
    Download on the App Store

    The Itch: Allergies, Asthma, Eczema & ImmunologyBy The Itch: Allergies, Asthma & Immunology

    • 4.3
    • 4.3
    • 4.3
    • 4.3
    • 4.3

    4.3

    92 ratings


    More shows like The Itch: Allergies, Asthma, Eczema & Immunology

    View all
    Stuff You Should Know by iHeartPodcasts

    Stuff You Should Know

    78,246 Listeners

    The Human Upgrade: Biohacking for Longevity & Performance by Dave Asprey

    The Human Upgrade: Biohacking for Longevity & Performance

    7,213 Listeners

    The Skinny Confidential Him And Her Show by Lauryn Bosstick and Michael Bosstick / Dear Media

    The Skinny Confidential Him And Her Show

    14,947 Listeners

    Frankly Speaking About Family Medicine by Pri-Med

    Frankly Speaking About Family Medicine

    262 Listeners

    The Curbsiders Internal Medicine Podcast by The Curbsiders Internal Medicine Podcast

    The Curbsiders Internal Medicine Podcast

    3,333 Listeners

    Calm Parenting Podcast by Kirk Martin

    Calm Parenting Podcast

    1,450 Listeners

    Dhru Purohit Show by Dhru Purohit

    Dhru Purohit Show

    3,522 Listeners

    The Dr. Hyman Show by Dr. Mark Hyman

    The Dr. Hyman Show

    9,233 Listeners

    AAAAI Podcast: Conversations from the World of Allergy by The American Academy of Allergy, Asthma & Immunology (AAAAI)

    AAAAI Podcast: Conversations from the World of Allergy

    51 Listeners

    The Bible Recap by Tara-Leigh Cobble

    The Bible Recap

    35,727 Listeners

    AllergyTalk by allergytalk

    AllergyTalk

    51 Listeners

    Bendy Bodies with Dr. Linda Bluestein by Dr. Linda Bluestein

    Bendy Bodies with Dr. Linda Bluestein

    221 Listeners

    Huberman Lab by Scicomm Media

    Huberman Lab

    29,210 Listeners

    Good Inside with Dr. Becky by Dr. Becky Kennedy

    Good Inside with Dr. Becky

    4,535 Listeners

    The Mel Robbins Podcast by Mel Robbins

    The Mel Robbins Podcast

    20,335 Listeners