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carcinoid syndrome : ウィキペディア英語版
carcinoid syndrome

Carcinoid syndrome refers to the array of symptoms that occur secondary to carcinoid tumors. The syndrome includes flushing and diarrhea, and, less frequently, heart failure and bronchoconstriction. It is caused by endogenous secretion of mainly serotonin and kallikrein.
==Signs and symptoms==

The carcinoid syndrome occurs in approximately 5% of carcinoid tumors and
becomes manifest when vasoactive substances from the tumors enter the systemic circulation escaping hepatic degradation. Interestingly, if the primary tumor is from the GI tract (hence releasing serotonin into the hepatic portal circulation), carcinoid syndrome generally does not occur until the disease is so advanced that it overwhelms the liver's ability to metabolize the released serotonin.
* Flushing: The most important clinical finding is flushing of the skin, usually of the head and the upper part of thorax.〔E.Goljan, ''Pathology, 2nd ed'' Mosby Elsevier, Rapid Review series.〕 Secretory diarrhea and abdominal cramps are also characteristic features of the syndrome.
* Diarrhea: When the diarrhea is intensive it may lead to electrolyte disturbance and dehydration. Other associated symptoms are nausea, and vomiting. Bronchoconstriction, which may be histamine-induced, affects a smaller number of patients and often accompanies flushing.
* Secondary restrictive cardiomyopathy: About 50% of patients have cardiac abnormalities classically of the restrictive-type caused by serotonin-induced fibrosis of the valvular endocardium, notably the tricuspid and pulmonary valves, called cardiac fibrosis. This results in a heart with normal rhythm and contractility, but reduced preload and end-diastolic volume. "TIPS" is an acronym for Tricuspid Insufficiency, Pulmonary Stenosis (fibrosis of tricuspid and pulmonary valves).
* Abdominal pain: Due to desmoplastic reaction of the mesentery or hepatic metastases.

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
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