ROBERT J. LEVINE, M.D.; ALBERT SJOERDSMA, M.D., PH.D.
It is generally accepted that overproduction of serotonin accounts for the major symptomatology of patients with the malignant carcinoid syndrome. When flushing reactions occur, however, certain facts lead one to question the primacy of serotonin in pathogenesis. With occasional exceptions (1, 2), it has not been possible to demonstrate increased concentrations of serotonin in association with spontaneous or induced flushes in carcinoid patients. Also, we have observed severe flushing in patients who had only slightly increased concentrations of the serotonin end-product, 5-hydroxyindoleacetic acid (5HIAA). Furthermore, it is difficult to induce flushes with serotonin, and those that are induced differ qualitatively
LEVINE RJ, SJOERDSMA A. Pressor Amines and the Carcinoid Flush. Ann Intern Med. ;58:818–828. doi: 10.7326/0003-4819-58-5-818
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Published: Ann Intern Med. 1963;58(5):818-828.
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