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However, the fact that most patients appear to have suffered for decades with multisystem inflammatory, allergic, and dystrophic issues consistent with the behavior of MCAS (i.e., dating back well before any infection likely would have occurred) makes clear these infections were not life-long primary issues driving purely secondary MCAS but rather were aggravants acquired at various points in the patients’ courses with their primary MCAS

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doi: 10.1016/j.jprot.2021.104385 467 YinK.LiR.ZhangS.SunY.HuangL.JiangM.et al