Low prevalence of osteoporosis in adult cutaneous mastocytosis patients

Published: February 27, 2024

Mastocytosis is a rare heterogeneous disorder responsible for cutaneous and systemic manifestations. Proliferation and activation of abnormal mast cells in mastocytosis can trigger various manifestations, including a condition of bone fragility named osteoporosis (OP), which increases risk for subsequent vertebral fractures. To date, we lack insight into the specific mast cell abnormalities responsible for OP in mastocytosis, particularly whether mast cell medullar clonality is sufficient to generate OP.

Degboé et al. recently published a retrospective study in The Journal of Allergy and Clinical Immunology: In Practice describing OP in patients with medullar clonality in 3 distinct forms of mastocytosis: cutaneous mastocytosis (CM), monoclonal mast cell activation syndrome (MMAS), and non-advanced systemic mastocytosis (SM). These patients from a French mastocytosis expert center (CEREMAST) were compared in terms of clinical, biological, and bone mineral density characteristics.

The authors reported data from 27 CM, 13 MMAS and 135 SM patients. All patients had clonal mast cells in the bone marrow. SM was the predominant form of mastocytosis associated with OP. Importantly, OP (respectively 3.7, 30.8 and 34.1%) and vertebral fractures (0.0, 15.4 and 20.0%) were less frequent in CM compared to MMAS and SM. These results suggest that OP is not a common finding in CM, and that mast cell medullar clonality is not sufficient to trigger OP in mastocytosis.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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