Hypertryptasemia and Mast Cell-Related Disorders in Severe Osteoporotic Patients

Table 1

Bone marrow assessment and clinical findings in osteoporotic patients with hypertryptasemia.

Pts	Sex	Age years	Serum tryptase (ng/ml)	Diagnosis	Bone marrow histology	Major criterion	Minor criteria				Comorbidities
							1	2	3	4
1	M	62	24.0	SM	Rare interstitial, perivascular, and paratrabecular MCs	-	-	+	+	+	Hypogonadism
2	M	41	26.0	SM	No MC infiltration, no MC granuloma	+	-	-	+	-	Active smoke, hypogonadism, alcoholism
3	F	65	19.2	SM	No MC infiltration, no MC granuloma	-	+	+	+	-	-
4	F	57	23.0	MCs alterations	No MC infiltration, no MC granuloma	-	+	-	-	-	-
5	M	70	16.3	MCs alterations	No MC infiltration, no MC granuloma	-	-	+	-	-	Hypogonadism, DM2, CKD, psoriatic arthropathy
6	M	73	15.4	MCs alterations	No MC infiltration, no MC granuloma	-	-	-	+	-	Adrenal incidentaloma, kidney stones, psoriasis
7	F	41	48.4	MCs alterations	Perivascular MC aggregates	-	-	-	+	+	IBD, pregnancy, lactation
8	M	79	21.0	PV	-	-	-	-	-	-	Previous prostate cancer, coronaropathy
9	M	62	12.7	Normal	-	-	-	-	-	-	Active smoke, MS
10	M	73	11.5	Normal	-	-	-	-	-	-	COPD
11	F	67	13.2	Normal	-	-	-	-	-	-	-
12	M	52	16.0	Normal	-	-	-	-	-	-	-
13	F	50	11.4	Normal	-	-	-	-	-	-	COPD, hypothyroidism
14	F	42	16.9	Normal	-	-	-	-	-	-	Previous anorexia nervosa
15	F	65	26	Normal	-	-	-	-	-	-	Iatrogenic thyrotoxicosis
16	M	79	18	Normal	-	-	-	-	-	-	Coronaropathy, MGUS

BM: bone marrow; SM: systemic mastocytosis; MCs: mast cells; PV: polycythemia vera; DM2: type 2 diabetes mellitus; CKD: chronic kidney disease; IBD: inflammatory bowel disease; MS: metabolic syndrome; COPD: chronic obstructive pulmonary disease. The diagnosis of SM can be made when the major criterion and at least 1 minor criterion are present or when ≥3 minor criteria are present [8, 9]. Major criterion: multifocal dense infiltrates of MCs (≥15 MCs in aggregates) in BM biopsies and/or in sections of other extracutaneous organ(s). Minor criteria: (1) >25% of all MCs are atypical cells (type I or type II) on BM smears or are spindle shaped in MC infiltrates detected on sections of visceral organs. (2) KIT point mutation at codon 816 in the BM or another extracutaneous organ. (3) MCs in BM or blood or another extracutaneous organ exhibit CD2 and/or CD25. (4) Baseline  ng/ml (in case of an unrelated myeloid neoplasm, item “d” is not valid as an SM criterion).