Is it necessary to repeat bone marrow biopsy for mastocytosis?

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Posted on Sat, 6 Jun 2015 in Blood Disorders
Question: Question: Do I need a repeat bone marrow biopsy to check for mastocytosis
HPI: My serum tryptase was elevated in Sept 2014 and when rechecked in May 2015. Both times it was ~25. My allergist recommended a bone marrow biopsy to look for mastocytosis, but my hematologist said I didn't need one because the bone marrow biopsy I had for investigation of anemia (not tested for mastocytosis) was normal in October 2011. In terms of symptoms, I get hives every once in a while for no identifiable reason. They often start at the site of my previous PICC line scars. I frequently have nausea and vomiting, occasionally get palpitations, and intermittently have unexplained fevers/chills.
I have chronic leukopenia NYD and anemia from a GI bleed but otherwise my blood work has been normal.
Should I have a repeat bone marrow with testing for mastocytosis, or is it ok to ignore the elevated tryptase because my marrow from 2011 was normal?
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Answered by Dr. Hardik Sanghvi 1 hour later
Brief Answer:
You should investigate for mastocytosis.

Detailed Answer:
Hi, dear
I have gone through your question.
I can understand your concern.
Your symptoms matched with mastocytosis. Moreover you have persistent high level of tryptase.
Serum tryptase level more than 20 ng / ml is one of the diagnostic criteria for mastocytosis.

You should investigate for mastocytosis.
You said you have done bone marrow biopsy in 2011 and it is normal.

But you have high tryptase level in sep 2014 & may 2015. So you may have chance mastocytosis.

You should go for bone marrow biopsy along with flow cytometry to check kit receptor on mast cells.

It will give you exact diagnosis.
Then you should take treatment accordingly.

Hope I have answered your question, if you have doubt then I will be happy to answer.
Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Hardik Sanghvi

Hematologist

Practicing since :2008

Answered : 7039 Questions

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