{"uid":"cap_DTOmkW90UtGKe2gKrFHDY","slug":"rema-clonality-score-calculator-lvarez-twose-2012-1d97742a","name":"REMA Clonality Score Calculator (Álvarez-Twose 2012)","description":"Álvarez-Twose 2012 REMA: male +1, female −1; serum baseline tryptase <15 μg/L −1, 15–25 0, >25 +2; pruritus, hives or angioedema present −2, absent +1; syncope or presyncope +3. Range −4 to +7. Clonality likely iff score ≥2. Caller assigns sex, sBt, cutaneous signs, and syncope. Not a medical device, not a diagnosis of SM, not WHO SM criteria. magent does not assay tryptase.","url":"https://api.magentlab.com/api/calc/rema","method":"GET","headers":{},"bodySchema":{"type":"object","$schema":"https://json-schema.org/draft/2020-12/schema","required":["input"],"properties":{"input":{"type":"object","required":["type","method"],"properties":{"type":{"type":"string","const":"http"},"method":{"enum":["GET","HEAD","DELETE"],"type":"string"},"headers":{"type":"object","additionalProperties":{"type":"string"}},"queryParams":{"type":"object","required":["sex","tryptase_ug_l","pruritus_hives_angioedema","syncope_or_presyncope"],"properties":{"sex":{"enum":["female","male"],"type":"string","description":"Sex as assigned by the caller (Álvarez-Twose 2012). male scores +1; female scores −1. Always one of these."},"tryptase_ug_l":{"type":"number","description":"Serum baseline tryptase (sBt) in μg/L (1-200). <15 scores −1; 15–25 inclusive scores 0; >25 scores +2. Equal to 15 is not <15; equal to 25 is not >25. magent does not assay tryptase."},"syncope_or_presyncope":{"type":"boolean","description":"Syncope or presyncope as assigned by the caller (Álvarez-Twose 2012). true scores +3; false scores 0."},"pruritus_hives_angioedema":{"type":"boolean","description":"Presence of pruritus, hives or angioedema as assigned by the caller (Álvarez-Twose 2012). true scores −2; false (absence) scores +1. Both branches score. magent does not take a history."}}}},"additionalProperties":false},"output":{"type":"object","required":["type"],"properties":{"type":{"type":"string"},"example":{"type":"object"}}}}},"responseSchema":null,"example":null,"exampleRequest":null,"tags":["x402"],"displayCostAmount":"0.005","displayCostAsset":"USDC","priceDynamic":false,"priceHint":null,"priceStatus":"priced","priceSource":"probe","requiresHandshake":false,"reviewCount":0,"rating":{"score":"0.00","successRate":"0.00","reviews":0,"stars":null,"state":"unrated"},"availabilityStatus":"unknown","priceObserved":null,"sessionDeposit":null,"pricing":{"kind":"static","summary":"$0.005/call","primary":{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.005","per":"call","confidence":"exact"},"accepted":[{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.005","per":"call","confidence":"exact"}]},"paymentMethods":[{"uid":"pm_2DHhxAhSBQSJ7in6hqRsF","protocol":"x402","methodType":"crypto","chain":"base","mode":"charge","costAmount":"0.005","costPer":"request","priority":0,"asset":"0x833589fCD6eDb6E08f4c7C32D4f71b54bdA02913","unit":"request","depositMicros":null,"planRef":null}],"brandName":null,"brandSlug":null,"brandBaseUrl":null,"brandDocsUrl":null,"whatItDoes":"Calculates the REMA score to estimate likelihood of mast cell clonality in patients with anaphylaxis or systemic reactions, based on sex, serum baseline tryptase, cutaneous symptoms, and syncope.","exampleAgentPrompt":"Calculate the REMA clonality score for a male patient with a serum baseline tryptase of 30 μg/L, no pruritus or hives, and a history of syncope.","exampleUseCases":[{"title":"Anaphylaxis workup clonality screen","prompt":"I have a female patient who had anaphylaxis — baseline tryptase is 18 μg/L, she had hives during the reaction, and no syncope. What's her REMA score and is clonality likely?"},{"title":"High tryptase no skin signs evaluation","prompt":"Run the REMA score for a male patient with a baseline tryptase of 40 μg/L, absent pruritus or hives, and presyncope during his reaction."},{"title":"Low tryptase female with cutaneous signs","prompt":"Calculate the REMA clonality score for a female patient — her tryptase is 10 μg/L, she had itching and hives, and no syncope or presyncope."}],"resultDescription":"Returns a numeric REMA score (range −4 to +7) and likely a flag indicating whether clonality is likely (score ≥2). Computed from the four caller-supplied variables: sex, serum baseline tryptase band, presence of cutaneous symptoms, and syncope/presyncope.","failureModes":["Missing required query parameters (sex, tryptase_ug_l, pruritus_hives_angioedema, syncope_or_presyncope) returns an error","Tryptase value out of accepted range (1–200 μg/L) may cause validation error","Invalid enum value for sex (not 'male' or 'female') returns a schema error","Service does not assay tryptase — caller must supply lab value independently","Not validated for pediatric populations or patients on tryptase-affecting therapies"],"whenToPreferThis":"Use this endpoint when you need to quickly compute the validated Álvarez-Twose 2012 REMA score for a patient with suspected mast cell clonality following anaphylaxis or systemic mast cell reactions, and you have already obtained the four required clinical inputs (sex, serum baseline tryptase, cutaneous signs, syncope). This is not a diagnostic tool for WHO-defined systemic mastocytosis and should not replace bone marrow biopsy or specialist evaluation.","instructions":null,"reviewSummary":null,"reviewSummaryHighlights":null,"reviewSummaryConcerns":null,"reviewSummaryGeneratedAt":null,"activationCount":0,"lastUsedAt":null,"lastSuccessfullyRanAt":null,"lastHealthCheckAt":"2026-09-14T07:11:23.400Z","isFirstParty":false}