Differentiating carcinoid syndrome from other diseases: Difference between revisions

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* [[Liver]] [[metastases]]
* [[Liver]] [[metastases]]
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* [[Sensitivity|Sensitive]] for detection of [[Liver (2)|liver]] [[metastases]]
*[[Sensitivity|Sensitive]] for detection of [[Liver (2)|liver]] [[metastases]]
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* Localization of [[carcinoid tumor]]
* Localization of [[carcinoid tumor]]
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|[[Sensitivity (tests)|Sensitive]] for detection o[[Liver (2)|f liver]] [[metastases]] if present
| style="background: #F5F5F5; padding: 5px;" |[[Sensitivity (tests)|Sensitive]] for detection o[[Liver (2)|f liver]] [[metastases]] if present
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* [[Biopsy]] and [[histopathology]]
* [[Biopsy]] and [[histopathology]]
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| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Irritable Bowel Syndrome]]<ref name="pmid18371141">{{cite journal |vauthors=Ford AC, Forman D, Bailey AG, Axon AT, Moayyedi P |title=Irritable bowel syndrome: a 10-yr natural history of symptoms and factors that influence consultation behavior |journal=Am. J. Gastroenterol. |volume=103 |issue=5 |pages=1229–39; quiz 1240 |date=May 2008 |pmid=18371141 |doi=10.1111/j.1572-0241.2007.01740.x |url=}}</ref><ref name="pmid28374308">{{cite journal |vauthors=Simren M, Palsson OS, Whitehead WE |title=Update on Rome IV Criteria for Colorectal Disorders: Implications for Clinical Practice |journal=Curr Gastroenterol Rep |volume=19 |issue=4 |pages=15 |date=April 2017 |pmid=28374308 |pmc=5378729 |doi=10.1007/s11894-017-0554-0 |url=}}</ref>
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Irritable Bowel Syndrome]]<ref name="pmid18371141">{{cite journal |vauthors=Ford AC, Forman D, Bailey AG, Axon AT, Moayyedi P |title=Irritable bowel syndrome: a 10-yr natural history of symptoms and factors that influence consultation behavior |journal=Am. J. Gastroenterol. |volume=103 |issue=5 |pages=1229–39; quiz 1240 |date=May 2008 |pmid=18371141 |doi=10.1111/j.1572-0241.2007.01740.x |url=}}</ref><ref name="pmid28374308">{{cite journal |vauthors=Simren M, Palsson OS, Whitehead WE |title=Update on Rome IV Criteria for Colorectal Disorders: Implications for Clinical Practice |journal=Curr Gastroenterol Rep |volume=19 |issue=4 |pages=15 |date=April 2017 |pmid=28374308 |pmc=5378729 |doi=10.1007/s11894-017-0554-0 |url=}}</ref><ref name="pmid12454865">{{cite journal |vauthors= |title=American Gastroenterological Association medical position statement: irritable bowel syndrome |journal=Gastroenterology |volume=123 |issue=6 |pages=2105–7 |date=December 2002 |pmid=12454865 |doi=10.1053/gast.2002.37095b |url=}}</ref><ref name="pmid27144627">{{cite journal |vauthors=Mearin F, Lacy BE, Chang L, Chey WD, Lembo AJ, Simren M, Spiller R |title=Bowel Disorders |journal=Gastroenterology |volume= |issue= |pages= |date=February 2016 |pmid=27144627 |doi=10.1053/j.gastro.2016.02.031 |url=}}</ref>
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* [[Abdominal|Abdomina]]<nowiki/>l [[Radiographic|radiograph]] to assess for [[Stool|stoo]]<nowiki/>l accumulation and determine the severity.  
* [[Abdominal|Abdomina]]<nowiki/>l [[Radiographic|radiograph]] to assess for [[Stool|stoo]]<nowiki/>l accumulation and determine the severity.  
* Age-appropriate [[colorectal cancer]] [[screening]] in all [[patients]]  
* Age-appropriate [[colorectal cancer]] [[screening]] in all [[patients]]  
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| style="background: #F5F5F5; padding: 5px;" |[[Rome IV criteria]]  
| style="background: #F5F5F5; padding: 5px;" |[[Rome IV criteria]]  
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| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Small intestine cancer|Malignant neoplasms of small intestine]]
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Small intestine cancer|Malignant neoplasms of small intestine]]<ref name="pmid23789703">{{cite journal |vauthors=McLaughlin PD, Maher MM |title=Primary malignant diseases of the small intestine |journal=AJR Am J Roentgenol |volume=201 |issue=1 |pages=W9–14 |date=July 2013 |pmid=23789703 |doi=10.2214/AJR.12.8492 |url=}}</ref><ref name="pmid17372046">{{cite journal |vauthors=Hatzaras I, Palesty JA, Abir F, Sullivan P, Kozol RA, Dudrick SJ, Longo WE |title=Small-bowel tumors: epidemiologic and clinical characteristics of 1260 cases from the connecticut tumor registry |journal=Arch Surg |volume=142 |issue=3 |pages=229–35 |date=March 2007 |pmid=17372046 |doi=10.1001/archsurg.142.3.229 |url=}}</ref><ref name="pmid17026561">{{cite journal |vauthors=Lepage C, Bouvier AM, Manfredi S, Dancourt V, Faivre J |title=Incidence and management of primary malignant small bowel cancers: a well-defined French population study |journal=Am. J. Gastroenterol. |volume=101 |issue=12 |pages=2826–32 |date=December 2006 |pmid=17026561 |doi=10.1111/j.1572-0241.2006.00854.x |url=}}</ref>
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| style="background: #F5F5F5; padding: 5px;" |[[MRI]] and [[MRI enteroscopy]] are other advance modalities to [[diagnose]] and [[Staging (pathology)|stage]] [[Small intestine cancer|small intestinal cancers]]
| style="background: #F5F5F5; padding: 5px;" |[[MRI]] and [[MRI enteroscopy]] are other advance modalities to [[diagnose]] and [[Staging (pathology)|stage]] [[Small intestine cancer|small intestinal cancers]]
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|[[Endoscopy|Enteroscopy]], [[capsule endoscopy]] and double balloon [[enteroscopy]]
| style="background: #F5F5F5; padding: 5px;" |[[Endoscopy|Enteroscopy]], [[capsule endoscopy]] and double balloon [[enteroscopy]]
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*[[Adenocarcinoma|Adenocarcinomas]] may be polypoid, infiltrating, or as annular constricting lesions is [[small intestine]].
*[[Adenocarcinoma|Adenocarcinomas]] may be polypoid, infiltrating, or as annular constricting lesions is [[small intestine]].
*[[Polyps]] and [[adenomas]] of [[small intestine]] are considered precursor lesions of [[adenocarcinoma]].
*[[Polyps]] and [[adenomas]] of [[small intestine]] are considered precursor lesions of [[adenocarcinoma]].
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| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Crohn disease]]<ref name="pmid18649092">{{cite journal |vauthors=Hara AK, Swartz PG |title=CT enterography of Crohn's disease |journal=Abdom Imaging |volume=34 |issue=3 |pages=289–95 |date=2009 |pmid=18649092 |doi=10.1007/s00261-008-9443-1 |url=}}</ref>
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Crohn disease]]<ref name="pmid18649092">{{cite journal |vauthors=Hara AK, Swartz PG |title=CT enterography of Crohn's disease |journal=Abdom Imaging |volume=34 |issue=3 |pages=289–95 |date=2009 |pmid=18649092 |doi=10.1007/s00261-008-9443-1 |url=}}</ref><ref name="BaumgartSandborn2012">{{cite journal|last1=Baumgart|first1=Daniel C|last2=Sandborn|first2=William J|title=Crohn's disease|journal=The Lancet|volume=380|issue=9853|year=2012|pages=1590–1605|issn=01406736|doi=10.1016/S0140-6736(12)60026-9}}</ref><ref name="FeuersteinCheifetz2017">{{cite journal|last1=Feuerstein|first1=Joseph D.|last2=Cheifetz|first2=Adam S.|title=Crohn Disease: Epidemiology, Diagnosis, and Management|journal=Mayo Clinic Proceedings|volume=92|issue=7|year=2017|pages=1088–1103|issn=00256196|doi=10.1016/j.mayocp.2017.04.010}}</ref><ref name="García-BoschOrdás2016">{{cite journal|last1=García-Bosch|first1=O.|last2=Ordás|first2=I.|last3=Aceituno|first3=M.|last4=Rodríguez|first4=S.|last5=Ramírez|first5=A. M.|last6=Gallego|first6=M.|last7=Ricart|first7=E.|last8=Rimola|first8=J.|last9=Panes|first9=J.|title=Comparison of Diagnostic Accuracy and Impact of Magnetic Resonance Imaging and Colonoscopy for the Management of Crohn’s Disease|journal=Journal of Crohn's and Colitis|volume=10|issue=6|year=2016|pages=663–669|issn=1873-9946|doi=10.1093/ecco-jcc/jjw015}}</ref>
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* [[Right lower quadrant abdominal pain resident survival guide|Right lower quadrant]] [[pain]]<nowiki/>s
* [[Right lower quadrant abdominal pain resident survival guide|Right lower quadrant]] [[pain]]
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| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Benign cutaneous flushing]]
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Benign cutaneous flushing]]<ref name="IziksonEnglish2006">{{cite journal|last1=Izikson|first1=Leonid|last2=English|first2=Joseph C.|last3=Zirwas|first3=Matthew J.|title=The flushing patient: Differential diagnosis, workup, and treatment|journal=Journal of the American Academy of Dermatology|volume=55|issue=2|year=2006|pages=193–208|issn=01909622|doi=10.1016/j.jaad.2005.07.057}}</ref><ref name="İkizoğlu2014">{{cite journal|last1=İkizoğlu|first1=Güliz|title=Red face revisited: Flushing|journal=Clinics in Dermatology|volume=32|issue=6|year=2014|pages=800–808|issn=0738081X|doi=10.1016/j.clindermatol.2014.02.019}}</ref><ref name="SadeghianRouhana2017">{{cite journal|last1=Sadeghian|first1=Azeen|last2=Rouhana|first2=Hailey|last3=Oswald-Stumpf|first3=Brittany|last4=Boh|first4=Erin|title=Etiologies and management of cutaneous flushing|journal=Journal of the American Academy of Dermatology|volume=77|issue=3|year=2017|pages=391–402|issn=01909622|doi=10.1016/j.jaad.2016.12.031}}</ref>
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| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mastocytosis|Systemic mastocytosis]]
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mastocytosis|Systemic mastocytosis]]<ref name="HartmannEscribano2016">{{cite journal|last1=Hartmann|first1=Karin|last2=Escribano|first2=Luis|last3=Grattan|first3=Clive|last4=Brockow|first4=Knut|last5=Carter|first5=Melody C.|last6=Alvarez-Twose|first6=Ivan|last7=Matito|first7=Almudena|last8=Broesby-Olsen|first8=Sigurd|last9=Siebenhaar|first9=Frank|last10=Lange|first10=Magdalena|last11=Niedoszytko|first11=Marek|last12=Castells|first12=Mariana|last13=Oude Elberink|first13=Joanna N.G.|last14=Bonadonna|first14=Patrizia|last15=Zanotti|first15=Roberta|last16=Hornick|first16=Jason L.|last17=Torrelo|first17=Antonio|last18=Grabbe|first18=Jürgen|last19=Rabenhorst|first19=Anja|last20=Nedoszytko|first20=Boguslaw|last21=Butterfield|first21=Joseph H.|last22=Gotlib|first22=Jason|last23=Reiter|first23=Andreas|last24=Radia|first24=Deepti|last25=Hermine|first25=Olivier|last26=Sotlar|first26=Karl|last27=George|first27=Tracy I.|last28=Kristensen|first28=Thomas K.|last29=Kluin-Nelemans|first29=Hanneke C.|last30=Yavuz|first30=Selim|last31=Hägglund|first31=Hans|last32=Sperr|first32=Wolfgang R.|last33=Schwartz|first33=Lawrence B.|last34=Triggiani|first34=Massimo|last35=Maurer|first35=Marcus|last36=Nilsson|first36=Gunnar|last37=Horny|first37=Hans-Peter|last38=Arock|first38=Michel|last39=Orfao|first39=Alberto|last40=Metcalfe|first40=Dean D.|last41=Akin|first41=Cem|last42=Valent|first42=Peter|title=Cutaneous manifestations in patients with mastocytosis: Consensus report of the European Competence Network on Mastocytosis; the American Academy of Allergy, Asthma & Immunology; and the European Academy of Allergology and Clinical Immunology|journal=Journal of Allergy and Clinical Immunology|volume=137|issue=1|year=2016|pages=35–45|issn=00916749|doi=10.1016/j.jaci.2015.08.034}}</ref><ref name="LeeWhittaker2008">{{cite journal|last1=Lee|first1=Jason K|last2=Whittaker|first2=Scott J|last3=Enns|first3=Robert A|last4=Zetler|first4=Peter|title=Gastrointestinal manifestations of systemic mastocytosis|journal=World Journal of Gastroenterology|volume=14|issue=45|year=2008|pages=7005|issn=1007-9327|doi=10.3748/wjg.14.7005}}</ref><ref name="pmid2002264">{{cite journal |vauthors=Horan RF, Austen KF |title=Systemic mastocytosis: retrospective review of a decade's clinical experience at the Brigham and Women's Hospital |journal=J. Invest. Dermatol. |volume=96 |issue=3 |pages=5S–13S; discussion 13S–14S |date=March 1991 |pmid=2002264 |doi= |url=}}</ref><ref name="SokolGeorgin-Lavialle2010">{{cite journal|last1=Sokol|first1=Harry|last2=Georgin-Lavialle|first2=Sophie|last3=Grandpeix-Guyodo|first3=Catherine|last4=Canioni|first4=Danielle|last5=Barete|first5=Stéphane|last6=Dubreuil|first6=Patrice|last7=Lortholary|first7=Olivier|last8=Beaugerie|first8=Laurent|last9=Hermine|first9=Olivier|title=Gastrointestinal involvement and manifestations in systemic mastocytosis|journal=Inflammatory Bowel Diseases|volume=16|issue=7|year=2010|pages=1247–1253|issn=1078-0998|doi=10.1002/ibd.21218}}</ref><ref name="pmid17063092">{{cite journal |vauthors=Bedeir A, Jukic DM, Wang L, Mullady DK, Regueiro M, Krasinskas AM |title=Systemic mastocytosis mimicking inflammatory bowel disease: A case report and discussion of gastrointestinal pathology in systemic mastocytosis |journal=Am. J. Surg. Pathol. |volume=30 |issue=11 |pages=1478–82 |date=November 2006 |pmid=17063092 |doi=10.1097/01.pas.0000213310.51553.d7 |url=}}</ref><ref name="KleeweinLang2011">{{cite journal|last1=Kleewein|first1=Kristin|last2=Lang|first2=Roland|last3=Diem|first3=Anja|last4=Vogel|first4=Tobias|last5=Pohla-Gubo|first5=Gabriela|last6=Bauer|first6=Johann W.|last7=Hintner|first7=Helmut|last8=Laimer|first8=Martin|title=Diffuse Cutaneous Mastocytosis Masquerading as Epidermolysis Bullosa|journal=Pediatric Dermatology|volume=28|issue=6|year=2011|pages=720–725|issn=07368046|doi=10.1111/j.1525-1470.2011.01479.x}}</ref><ref name="KatsudaOkada2008">{{cite journal|last1=Katsuda|first1=Shogo|last2=Okada|first2=Yoshikatsu|last3=Oda|first3=Yoshio|last4=Tanimoto|first4=Kazuo|last5=Takabatake|first5=Satoru|title=SYSTEMIC MASTOCYTOSIS WITHOUT CUTANEOUS INVOLVEMENT|journal=Pathology International|volume=37|issue=1|year=2008|pages=167–177|issn=13205463|doi=10.1111/j.1440-1827.1987.tb03144.x}}</ref>
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| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Asthma]] exacerbation  
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Asthma]] exacerbation<ref name="pmid22386508">{{cite journal |vauthors=Fuhlbrigge A, Peden D, Apter AJ, Boushey HA, Camargo CA, Gern J, Heymann PW, Martinez FD, Mauger D, Teague WG, Blaisdell C |title=Asthma outcomes: exacerbations |journal=J. Allergy Clin. Immunol. |volume=129 |issue=3 Suppl |pages=S34–48 |date=March 2012 |pmid=22386508 |pmc=3595577 |doi=10.1016/j.jaci.2011.12.983 |url=}}</ref><ref name="pmid16337448">{{cite journal |vauthors=Limb SL, Brown KC, Wood RA, Wise RA, Eggleston PA, Tonascia J, Adkinson NF |title=Irreversible lung function deficits in young adults with a history of childhood asthma |journal=J. Allergy Clin. Immunol. |volume=116 |issue=6 |pages=1213–9 |date=December 2005 |pmid=16337448 |doi=10.1016/j.jaci.2005.09.024 |url=}}</ref><ref name="pmid17468458">{{cite journal |vauthors=Aldington S, Beasley R |title=Asthma exacerbations. 5: assessment and management of severe asthma in adults in hospital |journal=Thorax |volume=62 |issue=5 |pages=447–58 |date=May 2007 |pmid=17468458 |pmc=2117186 |doi=10.1136/thx.2005.045203 |url=}}</ref><ref name="pmid19187331">{{cite journal |vauthors=Dougherty RH, Fahy JV |title=Acute exacerbations of asthma: epidemiology, biology and the exacerbation-prone phenotype |journal=Clin. Exp. Allergy |volume=39 |issue=2 |pages=193–202 |date=February 2009 |pmid=19187331 |pmc=2730743 |doi=10.1111/j.1365-2222.2008.03157.x |url=}}</ref><ref name="pmid11371411">{{cite journal |vauthors=Côté J, Bowie DM, Robichaud P, Parent JG, Battisti L, Boulet LP |title=Evaluation of two different educational interventions for adult patients consulting with an acute asthma exacerbation |journal=Am. J. Respir. Crit. Care Med. |volume=163 |issue=6 |pages=1415–9 |date=May 2001 |pmid=11371411 |doi=10.1164/ajrccm.163.6.2006069 |url=}}</ref><ref name="DoughertyFahy2009">{{cite journal|last1=Dougherty|first1=R. H.|last2=Fahy|first2=J. V.|title=Acute exacerbations of asthma: epidemiology, biology and the exacerbation-prone phenotype|journal=Clinical & Experimental Allergy|volume=39|issue=2|year=2009|pages=193–202|issn=09547894|doi=10.1111/j.1365-2222.2008.03157.x}}</ref>
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* Tachypnea
* Prolonged expiratory phase of respiration (decreased I:E ratio)
* Seated position with use of extended arms to support the upper chest (tripod position)
* +/- Pulsus paradoxus
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|[[Chest X ray]]
|[[Chest X ray]]
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* Loss of the normal pseudostratified structure of airway epithelium
* Increase in the proportion of goblet cells
* Fibrotic thickening of the sub-epithelial reticular basement membrane
* Increased numbers of myofibroblasts
* Increased vascularity
* Increased airway smooth muscle mass
* Increased extracellular matrix
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| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Anaphylaxis]]
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Anaphylaxis]]<ref name="pmid18596587">{{cite journal |vauthors=Peavy RD, Metcalfe DD |title=Understanding the mechanisms of anaphylaxis |journal=Curr Opin Allergy Clin Immunol |volume=8 |issue=4 |pages=310–5 |date=August 2008 |pmid=18596587 |pmc=2683407 |doi=10.1097/ACI.0b013e3283036a90 |url=}}</ref><ref name="pmid20944042">{{cite journal |vauthors=Tupper J, Visser S |title=Anaphylaxis: A review and update |journal=Can Fam Physician |volume=56 |issue=10 |pages=1009–11 |date=October 2010 |pmid=20944042 |pmc=2954079 |doi= |url=}}</ref><ref name="pmid12209078">{{cite journal |vauthors=Kemp SF, Lockey RF |title=Anaphylaxis: a review of causes and mechanisms |journal=J. Allergy Clin. Immunol. |volume=110 |issue=3 |pages=341–8 |date=September 2002 |pmid=12209078 |doi= |url=}}</ref><ref name="pmid21293765">{{cite journal |vauthors=Bjornsson HM, Graffeo CS |title=Improving diagnostic accuracy of anaphylaxis in the acute care setting |journal=West J Emerg Med |volume=11 |issue=5 |pages=456–61 |date=December 2010 |pmid=21293765 |pmc=3027438 |doi= |url=}}</ref><ref name="urlUsefulness and Limitations of Sequential Serum Tryptase for the Diagnosis of Anaphylaxis in 102 Patients - FullText - International Archives of Allergy and Immunology 2013, Vol. 160, No. 2 - Karger Publishers">{{cite web |url=https://www.karger.com/Article/Fulltext/339749 |title=Usefulness and Limitations of Sequential Serum Tryptase for the Diagnosis of Anaphylaxis in 102 Patients - FullText - International Archives of Allergy and Immunology 2013, Vol. 160, No. 2 - Karger Publishers |format= |work= |accessdate=}}</ref>
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|History of exposure to [[Insect allergy|insect]] stings,food alllergy,rubber latex,food [[Additives|additives,]],allergy to medications,physical factors such s excercise and cold
|History of exposure to [[Insect allergy|insect]] stings,food alllergy,rubber latex,food [[Additives|additives,]],allergy to medications,physical factors such s excercise and cold
|-
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |Histaminergic [[Angioedema]]
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |Histaminergic [[Angioedema]]<ref name="pmid28687103">{{cite journal |vauthors=Busse PJ, Smith T |title=Histaminergic Angioedema |journal=Immunol Allergy Clin North Am |volume=37 |issue=3 |pages=467–481 |date=August 2017 |pmid=28687103 |doi=10.1016/j.iac.2017.03.001 |url=}}</ref><ref name="pmid28818177">{{cite journal |vauthors=Hahn J, Hoffmann TK, Bock B, Nordmann-Kleiner M, Trainotti S, Greve J |title=Angioedema |journal=Dtsch Arztebl Int |volume=114 |issue=29-30 |pages=489–496 |date=July 2017 |pmid=28818177 |pmc=5569554 |doi=10.3238/arztebl.2017.0489 |url=}}</ref><ref name="pmid28405953">{{cite journal |vauthors=Bernstein JA, Cremonesi P, Hoffmann TK, Hollingsworth J |title=Angioedema in the emergency department: a practical guide to differential diagnosis and management |journal=Int J Emerg Med |volume=10 |issue=1 |pages=15 |date=December 2017 |pmid=28405953 |pmc=5389952 |doi=10.1186/s12245-017-0141-z |url=}}</ref><ref name="pmid23131076">{{cite journal |vauthors=Bernstein JA, Moellman J |title=Emerging concepts in the diagnosis and treatment of patients with undifferentiated angioedema |journal=Int J Emerg Med |volume=5 |issue=1 |pages=39 |date=November 2012 |pmid=23131076 |pmc=3518251 |doi=10.1186/1865-1380-5-39 |url=}}</ref><ref name="pmid23282406">{{cite journal |vauthors=Kaplan AP |title=Angioedema |journal=World Allergy Organ J |volume=1 |issue=6 |pages=103–13 |date=June 2008 |pmid=23282406 |pmc=3651192 |doi=10.1097/WOX.0b013e31817aecbe |url=}}</ref><ref name="Zuraw2008">{{cite journal|last1=Zuraw|first1=Bruce L.|title=Hereditary Angioedema|journal=New England Journal of Medicine|volume=359|issue=10|year=2008|pages=1027–1036|issn=0028-4793|doi=10.1056/NEJMcp0803977}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
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* Any allergy to insects stings , foods or any ingestion within previous 24 hours
* Any allergy to insects stings , foods or any ingestion within previous 24 hours
|-
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Medullary carcinoma of thyroid|Medullary Thyroid Carcinoma]]
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Medullary carcinoma of thyroid|Medullary Thyroid Carcinoma]]<ref name="pmid20627492">{{cite journal |vauthors=Pacini F, Castagna MG, Cipri C, Schlumberger M |title=Medullary thyroid carcinoma |journal=Clin Oncol (R Coll Radiol) |volume=22 |issue=6 |pages=475–85 |date=August 2010 |pmid=20627492 |doi=10.1016/j.clon.2010.05.002 |url=}}</ref><ref name="pmid24037980">{{cite journal |vauthors=Roy M, Chen H, Sippel RS |title=Current understanding and management of medullary thyroid cancer |journal=Oncologist |volume=18 |issue=10 |pages=1093–100 |date=2013 |pmid=24037980 |pmc=3805151 |doi=10.1634/theoncologist.2013-0053 |url=}}</ref><ref name="pmid24552221">{{cite journal |vauthors=Mian C, Perrino M, Colombo C, Cavedon E, Pennelli G, Ferrero S, De Leo S, Sarais C, Cacciatore C, Manfredi GI, Verga U, Iacobone M, De Pasquale L, Pelizzo MR, Vicentini L, Persani L, Fugazzola L |title=Refining calcium test for the diagnosis of medullary thyroid cancer: cutoffs, procedures, and safety |journal=J. Clin. Endocrinol. Metab. |volume=99 |issue=5 |pages=1656–64 |date=May 2014 |pmid=24552221 |doi=10.1210/jc.2013-4088 |url=}}</ref><ref name="pmid26494386">{{cite journal |vauthors=Bae YJ, Schaab M, Kratzsch J |title=Calcitonin as Biomarker for the Medullary Thyroid Carcinoma |journal=Recent Results Cancer Res. |volume=204 |issue= |pages=117–37 |date=2015 |pmid=26494386 |doi=10.1007/978-3-319-22542-5_5 |url=}}</ref><ref name="LeboulleuxBaudin2004">{{cite journal|last1=Leboulleux|first1=Sophie|last2=Baudin|first2=Eric|last3=Travagli|first3=Jean-Paul|last4=Schlumberger|first4=Martin|title=Medullary thyroid carcinoma|journal=Clinical Endocrinology|volume=61|issue=3|year=2004|pages=299–310|issn=0300-0664|doi=10.1111/j.1365-2265.2004.02037.x}}</ref>
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* Plasma fractionated [[Metanephrine|metanephrines]]
* Plasma fractionated [[Metanephrine|metanephrines]]
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Latest revision as of 20:07, 15 May 2019

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]

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) Abdominal MRI Somatostatin receptor scintigraphy [SRS], or Octreoscan Metaiodobenzylguanidine (MIBG) scintigraphy Other diagnostic studies Transthoracic echocardiography
Carcinoid Syndrome[2][3][4][5][6][7][8][9][10] Neuroendocrine tumor of midgut [11][12][13][14] +

Mild

+ + + +

Dermatitis

Diarrhea

Dementia

Metastatic tumors in the liver: Right upper quadrant pain, hepatomegaly, and early satiety

+ +/- +/- + + - + + + +
  • Valve thickening with retraction and reduction in the mobility of the tricuspid valve

Pathognomonic radiological sign of midgut NET.

Neuroendocrine tumor of lung[15][16][17][18] + + + + +
+ +/- +/- + + - + + Sensitive for detection of liver metastases if present + + - Typical low-grade:bland cells containing regular round nuclei with finely dispersed chromatin and inconspicuous small nucleoli.Mitotic figures are scarce and necrosis is absent.

Intermediate-grade atypical: presence of Neuroendocrine morphology and either necrosis or 2 to 10 mitoses per 10 HPF

Irritable Bowel Syndrome[19][20][21][22] +

Perioidic

- - - - - - - - - - - - - - - - Rome IV criteria
  • Recurrent abdominal pain, at least 1day/week in the last 3 months, a/s with 2 or more of the following criteria:

•Related to defecation

•Associated with a change in stool frequency

•Associated with a change in stool form (appearance)

Malignant neoplasms of small intestine[23][24][25] +/- +/- - - +/- - - +/- - * Abdominal mass - + Abdominal CT scan may be diagnostic of small intestine cancer. Findings on CT scan suggestive of small intestine cancer include intrinsic mass with a short segment of bowel wall thickening MRI and MRI enteroscopy are other advance modalities to diagnose and stage small intestinal cancers - - Enteroscopy, capsule endoscopy and double balloon enteroscopy Biopsy and histopathology
Crohn disease[26][27][28][29] +/- - - - - - - - - - - - - -
  • Focal ulcerations and acute and chronic inflammation
Benign cutaneous flushing[30][31][32] - - + - - - - - - - - - - - - - - - - - - -
Systemic mastocytosis[33][34][35][36][37][38][39] + + + + - +/- +/- + - - - - - -
Asthma exacerbation[40][41][42][43][44][45] - - - + + + - - + -
  • Tachypnea
  • Prolonged expiratory phase of respiration (decreased I:E ratio)
  • Seated position with use of extended arms to support the upper chest (tripod position)
  • +/- Pulsus paradoxus
- - - -- - - - Chest X ray -
  • Loss of the normal pseudostratified structure of airway epithelium
  • Increase in the proportion of goblet cells
  • Fibrotic thickening of the sub-epithelial reticular basement membrane
  • Increased numbers of myofibroblasts
  • Increased vascularity
  • Increased airway smooth muscle mass
  • Increased extracellular matrix
Anaphylaxis[46][47][48][49][50] + -/+ + + + +/- - + + - - - - - - - - - - History of exposure to insect stings,food alllergy,rubber latex,food additives,,allergy to medications,physical factors such s excercise and cold
Histaminergic Angioedema[51][52][53][54][55][56] +/- +/- + + + + - + + - - - - - - - - - -
  • Take proper clinical history of previous similar episodes
  • Medication history
  • Any allergy to insects stings , foods or any ingestion within previous 24 hours
Medullary Thyroid Carcinoma[57][58][59][60][61] - +/- +/- +/- - - - - - - - - - - - -

For metastasis

-

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