insight
Forum Junior
Topics: 13
Posts: 36
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If a patient has :
increased histamine release,
venous telangiectasia,
bronchoconstriction,
and edema,
what is the best test to confirm the diagnosis?
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| ngaybinhyen
Forum Guru
Topics: 23
Posts: 657
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Sounds like Carcinoid syndrome. If this is the case, then urinary excretion of 25 mg/day of 5-HIAA is diagnostic
* In general, flushing triggered by - catecholamines (exercise and emotional stimuli); - Injection of isoproterenol, pentagastrin, - eating in some patients. - ethanol
@ carcinoid flush (occurs 80% in carcinoid syndrome, dark red to violaceous and involves the head, neck, and upper trunk, 30sec-3min but may last for hours in bronchial carcinoid variant, BP falls or no change; Carcinoid tumors of the foregut produce a slightly different flush, characteristically bright salmon pink to red):
- most evidence points to the tachykinins, particularly neuropeptide K,
- attributed to histamine in patients with gastric carcinoids
* Flushing blocked by somatostatin.
* Serotonin does not cause flushing
* In addition to paroxysms of cutaneous vasodilatation, some patients also develop telangiectasia, primarily on the face and neck, which is most marked in the malar area. These patients may have the characteristic features of rosacea
++ Rx: - Somatostatin - Octreotide - Surgery - Chemotherapy (cytotoxic agent - mono or combined)
Figure 44-9 Long-lasting chronic flushing in a patient with long-standing carcinoid disease. Note the telangiectases.
Edited by ngaybinhyen on 09/05/08 - 11:27 AM
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| insight
Forum Junior
Topics: 13
Posts: 36
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| ngaybinhyen
Forum Guru
Topics: 23
Posts: 657
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So, insight, is it a particular case of gastric carcinoid?
Can you post the whole question?
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| insight
Forum Junior
Topics: 13
Posts: 36
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My friend, its is the whole question as I found it.
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| Eagle_303
Forum Guru
Topics: 77
Posts: 655
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In carcinoid histamine may release but actual major compound is serotonine not histamine
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| nightflight1945
banned
Topics: 32
Posts: 920
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symptomatic carcinoid syndrome can be one of these two options:
1-Metastatic GI carcinoid to liver(without metastasis it can't cause symptoms)
2-intrabronchial
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| ngaybinhyen
Forum Guru
Topics: 23
Posts: 657
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carcinoid tumors in which blood draining bypasses the liver will cause carcinoid syndrome. That's why in small bowel tumor, there need to be a metastasis to have the syndrome
other sites (lung, ovary) --> drain directly to systemic system
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