Systemic Mastocytosis (SM) is one of the subtypes of mast cell disorders. Patients with SM suffer from flushing, abdominal cramps and hypotension. It may also cause unexplained and recurrent anaphylactic episodes sometimes. The secretion of mediators can be triggered by various factors.

Non-steroidal anti-inflammatory drugs (NSAIDs) are extensively used for their analgesic, antipyretic and anti-inflammatory properties, and they are one of the most commonly prescribed drugs in the world. On the other hand, they may cause a group of adverse reactions, ranging from mild reactions like gastritis to life-threatening allergic reactions like anaphylaxis.

In this paper, we report a patient who had multiple severe adverse reactions against NSAIDs and was referred to our clinic to find a safe alternative NSAID. She was eventually diagnosed with Indolent SM (ISM) when she was evaluated with all of her systemic complaints and symptoms.