1. INTRODUCTION
Mastocytosis is a rare disease caused by the abnormal proliferation of
mast cells. The prevalence of mastocytosis is estimated to be 13 per
100000 in all age categories [1,2]. Systemic mastocytosis is a
genetic disorder and is most commonly caused by a point mutation in the
gene for tyrosine kinase receptor Kit D816 V. The symptoms of
mastocytosis are quite diverse as mast cells accumulate in various
organs, especially the bone marrow, skin, liver, spleen, and lymph
nodes. Histamine, heparin, and tryptase are the most recognized
preformed mediators that are released from mast cells. Newly formed
mediators at the time of the reaction include prostaglandins,
leukotrienes, chemokines and cytokines [3]. Mast cell mediator
release can lead to general symptoms such as abdominal pain, urticaria,
pruritus, syncope, and vascular collapse, including death in severe
cases. Common triggers are insect stings and drugs, including
nonsteroidal anti-inflammatory drugs (NSAIDs), anesthetics, antibiotics,
food, and mechanical stimulation [2]. Stress and pain during labor
and delivery can activate the disease [3, 4]. Here, we report the
case of a pregnant woman with systemic mastocytosis who received
epidural analgesia to avoid labor pain.