# REMA Clonality Score Calculator (Álvarez-Twose 2012)

> REMA Clonality Score Calculator (Álvarez-Twose 2012) is a paid API for AI agents from api.magentlab.com, paid per call via x402, $0.005/call, status unknown (last checked 2026-09-14).

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.

## Facts

- Endpoint: GET https://api.magentlab.com/api/calc/rema
- Price: $0.005/call
- Payment: x402
- Status: unknown
- Last checked: 2026-09-14
- Activations on Zero: 0
- Tags: x402
- Canonical page: https://www.zero.xyz/c/rema-clonality-score-calculator-lvarez-twose-2012-1d97742a
- Structured record (JSON): https://api.zero.xyz/v1/capabilities/cap_DTOmkW90UtGKe2gKrFHDY

Status and success rate cover calls made through Zero and Zero's own probes. Third-party monitors may report differently.

## How to call it through Zero

Zero handles the 402 payment challenge and records the run. With the Zero CLI installed (`npm i -g @zeroxyz/cli`):

```sh
zero fetch --capability rema-clonality-score-calculator-lvarez-twose-2012-1d97742a
```

Example prompt: 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.

## When to prefer this

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.

## Known failure modes

- 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

## How this service works

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.

## Output

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.

## Request schema (JSON Schema)

```json
{
 "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"
    }
   }
  }
 }
}
```

## More

- Live health (JSON, refreshed every minute): https://www.zero.xyz/c/rema-clonality-score-calculator-lvarez-twose-2012-1d97742a/health.json
- [Zero catalog index](https://www.zero.xyz/llms.txt)
- [Other services from api.magentlab.com](https://www.zero.xyz/host/api.magentlab.com/llms.txt)