REMA score (clonal mast-cell disease prediction)

Predicts clonal mast-cell disease (e.g., indolent systemic mastocytosis) in patients with mast-cell-activation symptoms but no skin lesions, to guide whether to pursue bone-marrow study.

Evidence tier: Validated instrument.

Formula / logic

Sum of: sex (male +1 / female −1) + symptoms (pruritus/urticaria/angioedema present −2 / absent +1) + presyncope or syncope (+3 / 0) + baseline tryptase (<15 → −1; 15-25 → 0; >25 → +2). Range −4 to +7. Score ≥2 predicts clonal mast-cell disease.

Interpretation

Derived/validated by the Spanish Network on Mastocytosis (REMA) in adults with systemic MC-activation symptoms and no cutaneous mastocytosis. A score ≥2 had ~0.92 sensitivity and ~0.81 specificity for clonal MC disease.

Evidence & citations

  1. Alvarez-Twose I, González de Olano D, Sánchez-Muñoz L, et al. Clinical, biological, and molecular characteristics of clonal mast cell disorders presenting with systemic mast cell activation symptoms. J Allergy Clin Immunol. 2010;125(6):1269-1278.e2. PMID 20434205

Clinician decision support. Verify against the cited source. Not a substitute for clinical judgment. 100% on-device; no patient data is stored or transmitted.