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The last time Melanie Wardell was thrown into anaphylactic shock, an ad for Macy’s was to blame.

Wardell, 45, was thumbing through a magazine and came upon one of those inserts daubed with perfume. Just the scent triggered her systemic mastocytosis, a rare disorder that leads to unpredictable allergic reactions. It knocked her completely unconscious.

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Incidents like that are rare but unavoidable for Wardell and most of the roughly 30,000 people in the U.S. with systemic mastocytosis, or SM. Beyond the risk of an anaphylactic episode, SM results in everyday symptoms including itchy skin spots, headache, dizziness, nausea, and other hallmarks of allergic reaction.

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