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Studies of Concentration Changes During Flushing and Pulmonary Removal of Serotonin in Malignant Carcinoid Syndrome.

Richard B. Davis, M.D.; and Yang Wang, M.D., F.A.C.P.
Ann Intern Med. 1964;60(4):720-721. doi:10.7326/0003-4819-60-4-720_2
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Four patients with metastatic carcinoids were studied by cardiac catheterization. Two patients had valvular disease (mean serum serotonin concentrations, 2.53 and 2.12 µg/ml); two did not (mean concentrations, 3.05 and 0.71 µg/ml). Before and during flushing simultaneous blood samples were obtained from the hepatic vein, pulmonary artery, and aorta for fluorometric assay of serotonin and histamine. Norepinephrine (8 µg), epinephrine (2 µg), and ethanol (20%, 10 ml) injected in the pulmonary artery, precipitated flushing. No change in serotonin during flushing occurred in one patient. In three patients moderate or striking elevations of plasma serotonin occurred in at least one attack


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