RT Journal
A1 Schneckloth RE, McIsaac WM, Page IH
T1 SErotonin metabolism in carcinoid syndrome with metastatic bronchial adenoma
JF Journal of the American Medical Association
JO Journal of the American Medical Association
YR 1959
FD July 4
VO 170
IS 10
SP 1143
OP 1147
DO 10.1001/jama.1959.03010100005003
UL http://dx.doi.org/10.1001/jama.1959.03010100005003
AB A patient three months after lobectomy for bronchial adenoma began to experience warm flushing of the face. After a second operation for closure of a perforated duodenal ulcer the episodes became more frequent and severe and were accompanied by vomiting and other manifestations of the carcinoid syndrome. The mean daily excretion of 5-hydroxyindoleacetic acid was found to be 77 mg., approximately 10 times the normal. The urinary excretion of serotonin metabolites was found to be unaffected by the two serotonin antagonists that were tried. Histamine given intravenously did not provoke the typical flushes, and chlorpromazine had little objective effect on their course. The most significant finding was the occurrence of a hydroxyindole, probably an oxidation product of serotonin, present in the carcinoid tissue in greater amounts than serotonin itself and excreted in the urine. Its existence may explain variations in the clinical details of the carcinoid syndrome.