Published in:
22-08-2023 | Carcinoid Tumor | Case Report
A case of carcinoid syndrome probably exacerbated by hemodialysis in which prochlorperazine maleate was effective
Authors:
Keiko Oda, Tomohiro Murata, Kayo Tsujimoto, Fumika Tanaka, Daisuke Takahashi, Ryosuke Saiki, Yosuke Hirabayashi, Akira Tsunoda, Kanako Saito, Hiroto Yuasa, Hiroshi Imai, Kan Katayama, Kaoru Dohi
Published in:
CEN Case Reports
|
Issue 2/2024
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Abstract
Carcinoid syndrome is caused by the release of serotonin and other substances, which commonly occurs due to liver metastasis of neuroendocrine tumors. It rarely occurs due to liver metastasis of neuroendocrine carcinoma. We report the case of a patient with liver metastasis of neuroendocrine carcinoma who suffered from acute abdominal pain and diarrhea triggered by hemodialysis. Various differential diagnoses were considered, but we concluded these symptoms to be probably caused by exacerbation of carcinoid syndrome, as the serum 5HIAA level was markedly elevated, and a drug with anti-serotonin activity was effective. Prochlorperazine maleate, which has anti-serotonin activity, was effective for these symptoms, and the patient was able to continue maintenance hemodialysis, which contributed to his quality of life and prognosis. We speculated the mechanism of carcinoid exacerbation was that substances such as serotonin had entered the systemic circulation via the increased extrahepatic shunt of the portal venous blood flow, entering the inferior vena cava and that this condition had been triggered by hemodialysis via the same mechanism as portal systemic encephalopathy.