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This explains why gabapentin is sometimes used in MCAS patients with: Neuropathic pain Burning or tingling sensations Refractory pruritus (uncomfortable skin sensation that causes an urge to scratch) Pain out of proportion to objective findings Sleep disturbance driven by discomfort Randomized controlled trials in other populations (including uremic pruritus and neuropathic itch) demonstrate significant reductions in itch severity, supporting its role in centrally mediated pruritus

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