Distinguishing features of idiopathic flushing and carcinoid syndrome.

Abstract

We compared the clinical and biochemical profiles of 11 patients with idiopathic flushing (IF) with those of eight patients with carcinoid syndrome (CS). Patients with IF were more often women, had a longer duration of symptoms, and were younger. Palpitations, syncope, and hypotension occurred only in patients with IF, while wheezing and abdominal pain occurred only with CS; diarrhea occurred in both types of patients. Elevated blood serotonin levels were present primarily in CS. Increased levels of urine 5-hydroxyindoleacetic acid was specific for CS but unsufficiently sensitive to detect all cases. Abnormalities of gut and vasoactive peptides failed to distinguish the two conditions. Flushing in carcinoid patients responds uniformly to octreotide (Sandostatin), but only one third of the patients with IF are relieved of the symptom. Patients with IF have features that distinguish them from individuals with flushing from other causes, such as CS, postmenopausal state, chlorpropamide-alcohol flush, panic attacks, medullary thyroid carcinoma, and autonomic epilepsy. Familiarity with the clinical and biochemical features of IF should facilitate evaluation and identification of these patients.

• Authors: L B Aldrich, A R Moattari, A I Vinik
• Journal: Archives of internal medicine (Arch Intern Med) Vol. 148 Issue 12 Pg. 2614-8 (Dec 1988) ISSN: 0003-9926 [Print] United States
• PMID: 2461688 (Publication Type: Case Reports, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Serotonin
• Hydroxyindoleacetic Acid
• Octreotide

Topics

• Adult
• Diagnosis, Differential
• Female
• Flushing (etiology, metabolism, physiopathology)
• Humans
• Hydroxyindoleacetic Acid (urine)
• Male
• Malignant Carcinoid Syndrome (complications, diagnosis, metabolism, physiopathology)
• Middle Aged
• Octreotide (therapeutic use)
• Serotonin (blood)