Dr. Monthropey: Just a question…we’re taught that NSAIDs degranulate mast cells,
making things worse. How can they be effective therapy?
Dr. Afrin: They certainly can make things worse for some patients, and then clearly for
other patients they can be inhibitory, though the doses required typically are beyond
what most physicians are used to using.
Dr. Sibbald: NSAIDs can be dangerous in mast cell disease. Before we had some of
the better long-acting non-sedating H1 antihistamines, we used to exercise people to
deplete their histamine, and often they would clinically improve just through exercising 2-
4 times a day.