Webinar #3 (2023): Mast Cell Activation Syndrome Overview for POTS Practitioners | Dr Lawrence Afrin

Dr. Lawrence Afrin provides a practitioner-focused overview of Mast Cell Activation Syndrome (MCAS) with emphasis on its frequent overlap with POTS/dysautonomia. He outlines how MCAS commonly presents with fluctuating, multi‑system symptoms (including cardiovascular, gastrointestinal, dermatologic, neurologic, and respiratory) that may exacerbate orthostatic intolerance. For diagnosis, he highlights a clinical pattern-based approach: careful history, ruling out other causes, targeted but imperfect biomarkers (e.g., recognizing that serum tryptase can be normal), and documenting benefit from mast cell–directed therapy. Management centers on identifying and avoiding individualized triggers, gradual and layered pharmacotherapy (e.g., H1/H2 antihistamines, leukotriene modifiers, mast cell stabilizers, and other adjuncts as needed), and integrating care for dysautonomia (fluids, salt, compression, graded activity) while titrating treatments slowly to improve tolerance. The session equips clinicians to recognize MCAS in POTS patients, select pragmatic testing, and implement stepwise, personalized treatment plans.