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Abnormal Cutaneous Innervation in Multiple Endocrine Neoplasia, Type 2b

J. A. CARNEY, M.D., Ph.D.; A. B. HAYLES, M.D.; A. G. E. PEARSE, M.D.; H. O. PERRY, M.D.; and G. W. SIZEMORE, M.D.
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▸Requests for reprints should be addressed to J. A. Carney, M.D.; Mayo Clinic, 200 First Street SW: Rochester, MN 55901.

Mayo Clinic and Medical School; Rochester, Minnesota. Royal Postgraduate Medical School; London, England

Ann Intern Med. 1981;94(3):362-363. doi:10.7326/0003-4819-94-3-362
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In 1972 Baum (1) reported an abnormal histamine skin test in a patient with medullary thyroid carcinoma, pheochromocytoma, and mucosal neuromas—multiple endocrine neoplasia, type 2b (2); there was no flare around the wheal. Baum proffered two hypothetical explanations for the defect: an abnormal axon reflex due to a neural lesion; and rapid degradation of histamine by a substance, such as histaminase, secreted by medullary thyroid carcinoma. Herein we confirm Baum's finding of an abnormal response to histamine skin test in patients with multiple endocrine neoplasia, type 2b; report diffuse enlargement of cutaneous nerves in these patients; and suggest a possible


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