25/02/2026
Here’s why we’re only hearing more about it now:
1️⃣ The definition is recent
• 1991: Researchers first proposed the idea of dysfunctional mast cells without overproduction.
• 2007: The first formal MCAS cases were published.
• 2010: Initial diagnostic criteria were introduced (revised in 2019).
Most practising clinicians were never taught about MCAS during medical training.
2️⃣ It doesn’t look like other mast cell diseases
The historically recognised condition was Mastocytosis — where patients produce too many mast cells.
MCAS is different: mast cells are normal in number but abnormally reactive, releasing inflammatory chemicals like histamine in response to everyday triggers such as food, stress, or temperature shifts.
3️⃣ It’s difficult to diagnose
• Symptoms affect multiple systems (skin, gut, heart, brain, joints).
• It can mimic IBS, allergies, anxiety, chronic fatigue, and more.
• Lab testing requires catching chemical markers during a flare — and these markers degrade quickly if not handled precisely.
4️⃣ The Long COVID connection
Viral infections are known triggers for immune dysregulation. Since the COVID-19 pandemic, there has been a rise in patients presenting with symptoms consistent with mast cell activation, prompting accelerated research and awareness.
5️⃣ The power of patient advocacy
Online communities have helped identify patterns, including overlap between MCAS, POTS (Postural Orthostatic Tachycardia Syndrome), and hypermobile Ehlers-Danlos Syndrome (hEDS). Shared data and advocacy have played a major role in increasing medical recognition.
Sometimes a condition isn’t “new.”
It’s just newly understood.
MCAS highlights how evolving medical research changes what we recognise, diagnose, and treat. Many patients lived for years without answers — not because their symptoms weren’t real, but because the framework to explain them didn’t yet exist.
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info@mlcinfo.co.za
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