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The most common laboratory tests for MCAS include: Serum tryptase : An enzyme released by activated mast cells N-methylhistamine : A breakdown product of histamine measured in 24-hour urine Prostaglandin D2 or its metabolites: Measured in blood or urine Leukotriene E4 : Measured in 24-hour urine Chromogranin A : A marker for neuroendocrine activity It's important to note that many MCAS patients have normal tryptase levels between reactions, and some have normal levels even during reactions