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Abstracts |

Effects of Beta-Adrenergic Blockade in the Carcinoid Syndrome.

George D. Ludwig, M.D., F.A.C.P.; William Cushard, M.D.; Doris Bartuska, M.D.; Roberto Franco, M.D.; and Louis Chaykin, M.D.
Ann Intern Med. 1968;68(5):1188. doi:10.7326/0003-4819-68-5-1188_2
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Although serotonin may be responsible for the diarrhea of the carcinoid syndrome, recent evidence suggests that bradykinen induces the flushes and the vascular phenomena. A rise in hepatic venous bradykinen concentration accompanying flushing has been demonstrated, and a specific kallikrein has been isolated from carcinoid cells. Catecholamines can induce flushing attacks. Since intravenous epinephrine is more effective than norepinephrine in this regard and since alpha-adrenergic blocking agents are ineffective in carcinoid patients, a study of the effect of beta blockade in the carcinoid syndrome seemed warranted. Studies were made in four patients with metastatic carcinoid from primary ileal carcinoids.



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