ORAL DISODIUM-CROMOGLYCATE IN THE TREATMENT OF SYSTEMIC MASTOCYTOSIS

A double-blind crossover study of the efficacy of disodium cromoglycate given by mouth to control the cutaneous, gastrointestinal and Central-nervous-system manifestations of systemic mastocytosis was carried out in five patients for periods of eight to 32 months. In 15 of 18 trials, disodium cromoglycate produced marked amelioration of the clinical manifestations of pruritus, whealing, flushing, diarrhea, abdominal pain and disorders of cognitive function. By contrast, in all 19 trials with placebo, there was no improvement in these symptoms and signs. Histaminuria and peripheral-blood eosinophilia were unrelated to disease activity and were unaffected by drug therapy. Although it is poorly absorbed after administration by mouth, disodium cromoglycate is of clinical benefit to patients with systemic mastocytosis. (N Engl J Med 301:465–469, 1979) MASTOCYTOSIS, a condition characterized by the accumulation of mast cells in various organs of the body, presents in a limited cutaneous or a systemic form. Mast-cell proliferation limited to the skin is termed urticaria pigmentosa, and the dermal infiltrates may occur as a solitary nodule known as a mastocytoma or as widely distributed multiple papular lesions. In systemic mastocytosis, proliferations of mast cells can occur in the bones, liver, spleen, lymph nodes and gastrointestinal tract as well as the skin, and the mast cells may rarely appear in the blood.1 The clinical symptoms and signs of mastocytosis have been attributed. © 1979, Massachusetts Medical Society. All rights reserved.