MCAS Diagnosis Test Part 1
QUESTIONNAIRE TO IDENTIFY HYPERSENSITIVITY (HS), ALLERGIES, MCAS, HISTAMINOSIS AND TRYPTASEMIA IN PATIENTS WITH LONG COVID, POST-VACCINE SYNDROME AND OTHER CHRONIC DISEASES(Dr. Gustavo Aguirre-Chang and Dr. Aurora Trujillo F.)If you are not a medical professional using this diagnostic screening questionnaire and have difficulties understanding the text (because of potential 'brainfog' or reduced cognitive function, which is often the case when suffering from MCAS/HHM Syndrom), it is recommended to seek support from a family member or caregiver. For the most accurate translation of medical terminology we recommend to use the free deepl.com translator. Please find additional information and notes in the PDF here: HSA-MCAS Questionnaire
PART 1: SUMMARY QUESTIONNAIRE TO IDENTIFY HYPERSENSITIVITY (HS):
With just 3 questions, which the patient, their family members or caregivers can answer quickly at home, it will be established whether or not they are a patient with HS and Allergies.
1.1. CURRENT DISEASES WITH HS:
The patient currently suffers from: asthma, wheezing, allergies, rhinitis, nasal congestion, allergic conjunctivitis, hives, allergic dermatitis, histaminosis, histamine intolerance (HIT), lactose intolerance, wheat and gluten intolerance, soy, egg and/or fish or other food, DAO deficiency, mast cell activation syndrome (MCAS), mastocytosis, tryptasemia, HαT, or other disease with the presence of HS
1.2. PATHOLOGICAL HISTORY OF ACUTE EPISODES OF HISTAMINOSIS:
The patient has ever had a strong acute reaction or anaphylaxis: with swelling of the eyelids and/or lips; or with shortness of breath or difficulty breathing; or with hypotension, fainting, syncope, loss of consciousness and/or sphincter relaxation
1.3. LABORATORY ANALYSIS AND OTHER EXAMS:
In the last 2 years, the patient has had any examination that indicates any HS, allergy or histamine, such as: significant elevation of IgE, Eosinophils, Tryptase or Histamine; DAO deficiency; bone marrow or skin biopsy with mast cell disorder
MCAS Diagnosis Test Part 2
QUESTIONNAIRE TO IDENTIFY GASTROINTESTINAL AND OTHER SYMPTOMSASSOCIATED WITH ELEVATION OF HISTAMINE (HISTAMINOSIS), TRIPTASE(TRIPTASEMIA) AND OTHER INFLAMMATORY MEDIATORS.
The patient has some of the following persistent or recurrent symptoms (please check the applicable boxes):
MCAS Diagnosis Test Part 3
COMPLEMENTARY QUESTIONNAIRE TO IDENTIFY TRIGGER AGENTS OR ALLERGENS AND TO DETERMINE THE SEVERITY OF HS:
3.1. CURRENT DISEASES WHITH HS:
You currently suffer from any of the following diseases:
3.2. PATHOLOGICAL AND FAMILY HISTORY OF HS:
3.3 LABORATORY ANALYSIS AND OTHER EXAMS THAT INDICATE HS:
In the last 2 years, have you had any tests that indicate an allergy, the presence of HS or autoimmunity, such as (you can mark several answers):
Please finalize the test now by pressing 'Submit' below. Thank you.