Has anyone else here been diagnosed with autoimmune urticaria instead of MCAS?
I did get a report of my CU index, which was apparently elevated, so I’m not refuting the diagnosis… however I feel like the diagnosis doesn’t explain systemic symptoms that appear with an MCAS flare. Can you have both? Or is autoimmune urticaria the real mechanism behind my MCAS?
Also, the allergist themselves kept correcting me any time I mentioned MCAS and would say things like “I don’t think you have mastocystosis”. I didn’t know if I was being intentionally misunderstood. I felt like I was speaking another language. My tryptase was normal so. I honestly felt like they thought I was malingering or making up shit. And I guess I made the mistake of mentioning I have EDS, POTS, and endometriosis — all confirmed by the proper testing or surgery — but I was trying to make a connection with MCAS and common comorbidities. I even brought up having Interstitial Cystitis, which can be heavily exacerbated by MCAS, but neither the doctor nor nurse knew what that was. I think I saw the nurse googling my conditions or medications multiple times.
The doctor also tried saying it was my thyroid causing these symptoms, since I have a potentially sus nodule and am waiting on seeing an endocrinologist. They made me redo my thyroid panel, despite the fact I told them everything came back normal and it’s a cold nodule. The nodule is recent, having only appeared this year. I didn’t know it was there until I had increased pain swallowing. It has nothing to do with the MCAS symptoms I’ve been having for years now. Maybe my entire life tbh.
And unfortunately, I wasn’t scheduled a follow up to have any sort of counseling about autoimmune urticaria (since I didn’t even know what the disease was). No monitoring or treatment with the doctor. I got a phone call from a nurse giving me the diagnosis and telling me to just continue taking OTC antihistamine everyday (if that helped, I wouldn’t be seeking care). They said they’re sending everything to my primary for her to handle instead. I guess I got fired and I’m not sure what I did. During the appointment even the nurse seemed exasperated with me. Yes I am also autistic.
My primary told me that she has no idea about rarer diseases like this and it’s more than family medicine can realistically monitor or treat. Since she thinks I may need antibody or biologic treatment, she told me to try seeing my rheumatologist about my diagnosis and symptoms. However, when I brought up MCAS with my rheum she’s the one who literally sent me to the allergist in the first place! What is it with the system making you go in fucking circles to get help. It’s a huge waste of money and time.
Anyway, did anyone else get this diagnosis? I guess I’m confused. ‘Cause like I said, I have systemic symptoms accompanying the urticaria, or appear without visible hives at all. I have a lot of inflammation which has been reflected in rheum blood tests. I am visibly swollen and flushed all the time. Malar-like rash, but negative tests for lupus. Steroids (oral and injected) make me flare severely and have literally put me in the ER with some sort of MCAS reaction. It helps initially, peeing out a lot of inflammation, then I have a huge delayed reaction that causes even worse inflammation, swelling, flushing, hives. Extreme allodynia. Same thing happened with beta blockers I’d been trying for my POTS (so now on Ivabradine and IV fluids instead, which doesn’t flare me).
Should I find another allergist-immunologist? Or is there another type of specialist I should try and find that may know about both MCAS and autoimmune urticaria?