Carcinoid syndrome and carcinoid heart disease
Flushing, diarrhoea and wheezing caused by hormones (mostly serotonin) released by some neuroendocrine tumours; over years it can scar the heart valves.
Occurs in ~20-30% of small-bowel NETs, usually with liver metastases. Somatostatin analogues control symptoms; telotristat ethyl (tryptophan hydroxylase inhibitor, 2017) treats refractory diarrhoea; 24-hour urinary 5-HIAA monitors; echocardiography screens for right-heart valve disease. Carcinoid crisis during anaesthesia or embolisation is prevented with octreotide infusion.
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