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MCAS patients may have a few key symptoms that are not typical in histamine intolerance 44 : 76% of people with MCAS have skin dermatographia, developing red marks lasting over 30 minutes after a light scratch on their skin Abnormal blood clotting or bleeding/bruising without other identifiable causes Strange food and medication reactions Symptoms may be severe and spontaneous, without provocation The American Academy of Allergy, Asthma & Immunology recommends the following blood tests to diagnose MCAS 45 : Serum mast cells tryptase, which is a marker of excessive mast cell activation 46 Normal 50 ng/mL Skin and bone marrow biopsies for increased mast cells