Differentiating carcinoid syndrome from other diseases: Difference between revisions
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Revision as of 18:12, 12 February 2019
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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:[1]
- 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 | Other symptoms | Wheezing | Telangiectasia | Hypotension | Tachycardia | Systolic murmur of tricuspid regurgitation | Other physical findings | Urinary 5-hydroxyindoleacetic acid (5-HIAA) | Serum Chromogranin A (CgA) | Other markers | Abdominal computed tomography (CT) | MRI | Somatostatin receptor scintigraphy [SRS], or Octreoscan | Metaiodobenzylguanidine (MIBG) scintigraphy | Other diagnostic studies |
| |||||
| Carcinoid Syndrome[2][3][4][5] | +
Mild |
+
|
+ | + | + |
Dermatitis Diarrhea Dementia |
+ | + | + | + | + | + |
|
+
|
|
|
|
Pathognomonic radiological sign of midgut NET. | |||||||
| Irritable Bowel Syndrome |
|
- | - | ||||||||||||||||||||||
| Systemic mastocytosis | - | ||||||||||||||||||||||||
| Malignant neoplasms of small intestine | |||||||||||||||||||||||||
| Benign cutaneous flushing | |||||||||||||||||||||||||
| Recurrent idiopathic anaphylaxis | |||||||||||||||||||||||||
| Crohn disease |
|
+/- | - | - | - |
|
- | - |
|
Endoscopy | |||||||||||||||
| Asthma exacerbation | - | - | - | + | + | + | - | - | + | - | - | - | Chest X ray | ||||||||||||
| Acute Urticaria | |||||||||||||||||||||||||
| Anaphylaxis | |||||||||||||||||||||||||
| Angioedema | |||||||||||||||||||||||||
| Drugs causing flushing |
| ||||||||||||||||||||||||
| Medullary Thyroid Carcinoma | |||||||||||||||||||||||||
References
- ↑ Metcalfe DD (2000). "Differential diagnosis of the patient with unexplained flushing/anaphylaxis". Allergy Asthma Proc. 21 (1): 21–4. PMID 10748948.
- ↑ Rubin de Celis Ferrari AC, Glasberg J, Riechelmann RP (August 2018). "Carcinoid syndrome: update on the pathophysiology and treatment". Clinics (Sao Paulo). 73 (suppl 1): e490s. doi:10.6061/clinics/2018/e490s. PMC 6096975. PMID 30133565.
- ↑ Hegyi J, Schwartz RA, Hegyi V (January 2004). "Pellagra: dermatitis, dementia, and diarrhea". Int. J. Dermatol. 43 (1): 1–5. PMID 14693013.
- ↑ Savelli G, Lucignani G, Seregni E, Marchianò A, Serafini G, Aliberti G, Villano C, Maccauro M, Bombardieri E (May 2004). "Feasibility of somatostatin receptor scintigraphy in the detection of occult primary gastro-entero-pancreatic (GEP) neuroendocrine tumours". Nucl Med Commun. 25 (5): 445–9. PMID 15100502.
- ↑ Savelli G, Lucignani G, Seregni E, Marchianò A, Serafini G, Aliberti G, Villano C, Maccauro M, Bombardieri E (May 2004). "Feasibility of somatostatin receptor scintigraphy in the detection of occult primary gastro-entero-pancreatic (GEP) neuroendocrine tumours". Nucl Med Commun. 25 (5): 445–9. PMID 15100502.