Differentiating carcinoid syndrome from other diseases

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Overview

Carcinoid syndrome must be differentiated from systemic mastocytosis, medullary thyroid carcinoma, irritable bowel syndrome, malignant neoplasms of the small intestine, benign cutaneous flushing, and recurrent idiopathic anaphylaxis.

Differentiating Carcinoid Syndrome from other Diseases

Carcinoid syndrome must be differentiated from:

• Systemic mastocytosis
• Medullary thyroid carcinoma
• Irritable bowel syndrome
• Malignant neoplasms of the small intestine
• Benign cutaneous flushing
• Recurrent idiopathic anaphylaxis

On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from [disease 1], [disease 2], [disease 3], [disease 4], [disease 5], and [disease 6].

Diseases		Clinical manifestations									Para-clinical findings									Gold standard	Additional findings
		Symptoms					Physical examination
											Lab Findings			Imaging					Histopathology
		Abdominal pain	Diarrhea	Flushing	Dyspnea	Palpitations	Wheezing	Telangiectasia	Hypotension		Lab 1	Serum Chromogranin A (CgA)	Lab 3	Abdominal computed tomography (CT)	MRI	somatostatin receptor scintigraphy [SRS], or Octreoscan	Metaiodobenzylguanidine (MIBG) scintigraphy	Echocardiography
Carcinoid Syndrome																				Urinary 5-hydroxyindoleacetic acid (5-HIAA)
Irritable Bowel Syndrome
Systemic mastocytosis
Malignant neoplasms of small intestine
Benign cutaneous flushing
Recurrent idiopathic anaphylaxis
Diseases		Symptom 1	Symptom 2	Symptom 3			Physical exam 1	Physical exam 2	Physical exam 3		Lab 1	Lab 2	Lab 3	Imaging 1		Imaging 2	Imaging 3		Histopathology	Gold standard	Additional findings
Crohn disease
Asthma
Differential Diagnosis 6