patient with mastocytosis a case reportLinda P Nelson DMD MScD Ilse SavelliCastillo DDS AbstractMastocytosis is a heterogeneous group of clinical disorders characterized by an excessivenumber ID: 942690
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Pediatric Dentistry 24:4, 2002Nelson, Savelli-Castillo 343Mastocytosis: case report patient with mastocytosis: a case reportLinda P. Nelson, DMD, MScD Ilse Savelli-Castillo, DDS AbstractMastocytosis is a heterogeneous group of clinical disorders characterized by an excessivenumber of normal mast cells in a variety of tissues (skin, bone marrow, liver, spleen andlymph nodes). It is most often seen in the skin in pediatric-onset mastocytosis present-ing as urticaria pigmentosa. Children with this disorder are on a strict avoidance protocolof triggering factors to decrease the likeliho
od of life-threatening anaphylactic reactions.Close monitoring and the avoidance of known histamine-releasing drugs is necessary inthe pediatric dental office, as is a readiness to use resuscitative measures.A case of a 4-year, 6-month-old pediatric dental patient with mastocytosis is presented.Dental treatment was provided in an ambulatory setting utilizing nitrous oxide, oxygenanalgesia and H1 and H2 antihistamines to prevent mast cell degranulation and to pro-vide sedation. (Pediatr Dent. 2002;24:343-346) with cutaneous mastocytosis. The tan to red-brown maculesbe involved. Clinical Sec
tion 344 Nelson, Savelli-CastilloPediatric Dentistry 24:4, 2002Mastocytosis: case report monitoring, the avoidance of known histamine-releasingnificant for the diagnosis of mastocytosis limited to multiplethat visit, as well. The radiographs confirmed the clinical Fig 1. Skin lesions associated with mastocytosis (Courtesy of TheMastocytosis Society, www.mastocytosis.com) Pediatric Dentistry 24:4, 2002Nelson, Savelli-Castillo 345Mastocytosis: case report six-month recall. Recallsmines would provide enough sedation to remove caries whenand no local anesthesia. Additionally, both Han
tihistamines inhibit the effects of histamine on cap- Fig 2. Intraoral radiographs 346 Nelson, Savelli-CastilloPediatric Dentistry 24:4, 2002Mastocytosis: case report toms of anaphylaxis due to mast cell degranulation, a codeChildren with systemic diseases, such as mastocytosis,1.Longley J, Duffy TP, Kohn S. The mast cell and mast2.Kettelhut BV, Metcalfe DD. Pediatric mastocytosis.3.Scott LM, Metcalfe DD. NIH Mastocytosis Informa-4.Pauls JD, Brems J, Pockros PJ, Saven A, Wagner RL,6.AAPD Guidelines for the elective use of conscious se-7.Malamed SF. The use of diphenhydramine HCl as