Carcinoid syndrome physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

A patient may present and verbally identify symptoms such as flushing and diarrhea or may not articulate them at all. During examination, evidence of T.I.P.S. - tricuspid insufficency pulmonic stenosis may appear. In many cases, increased levels of 5-HIAA may be found in urine specimens.

Physical Examination

Clinical findings include:

• Flushing of the skin
• Diarrhea and abdominal cramps
• Right sided heart disease
• Bronchoconstriction
• Abdominal pain due to desmoplastic reaction of the mesentery
• In most patients, increased urinary excretion of 5-HIAA (5-hydroxyindoleacetic acid), a degradation product of serotonin
• Serotonin causes fibrosis of the tricuspid valve and pulmonary valve
  • "TIPS" - Tricuspid Insufficiency, Pulmonic Stenosis (fibrosis of tricuspid and pulmonary valves)

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