Skip to main content
SpringerLink
Log in

A case of carcinoid syndrome probably exacerbated by hemodialysis in which prochlorperazine maleate was effective

  • Case Report
  • Published:
CEN Case Reports Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. https://docs.jsdt.or.jp/overview/file/2020/pdf/06.pdf. Accessed 28 July 2023

  2. Liu EH, Solorzano CC, Katznelson L, et al. AACE/ACE disease state clinical review: diagnosis and management of midgut carcinoids. Endocr Pract. 2015;21:534–45.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Halperin DM, Shen C, Dasari A, et al. Frequency of carcinoid syndrome at neuroendocrine tumour diagnosis: a population-based study. Lancet Oncol. 2017;18:525–34.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Taal BG, Visser O. Epidemiology of neuroendocrine tumours. Neuroendocrinology. 2004;80(Suppl 1):3–7.

    Article  CAS  PubMed  Google Scholar 

  5. Ubara Y, Hoshino J, Tagami T, et al. Hemodialysis-related portal-systemic encephalopathy. Am J Kidney Dis. 2004;44:e38–42.

    Article  PubMed  Google Scholar 

  6. Klimstra D, Klöppel G, La Rosa S, et al. Classification of neuroendocrine neoplasm of the digestive system. In: WHO Classification of Tumours Editorial Board, editor. WHO classification of tumours, digestive system tumours. 5th edn, vol. 1. Lyon: World Health Organization; 2019. p. 16–21.

  7. Georgiadou F, Moutzouris DA, Kassimatis TI, et al. Recurrent flushing in a hemodialysis patient. Semin Dial. 2006;19:558–9.

    Article  PubMed  Google Scholar 

  8. Irvin MM, Mard K, Igor L, et al. Current status of gastrointestinal carcinoids. Gastroenterology. 2005;128:1717–51.

    Article  Google Scholar 

  9. Fandulli G, Ruggeri RM, Glossrubatscher E, et al. Serotonin pathway in carcinoid syndrome: clinical, diagnostic, prognostic and therapeutic implications. Rev Endocr Metab Disord. 2020;21:599–612.

    Article  Google Scholar 

  10. Adaway JE, Dobson R, Walsh J, et al. Serum and plasma 5-hydroxyindoleacetic acid as an alternative to 24-h urine 5-hydroxyindoleacetic acid measurement. Ann Clin Biochem. 2015;52:554–60.

    Google Scholar 

  11. Sebekova K, Spustova V, Opatrny K Jr, et al. Serotonin and 5-hydroxyindole-acetic acid. Bratisl Lek Listy. 2001;102:351–6.

    CAS  PubMed  Google Scholar 

  12. Kvols LK, Moertel CG, O’Connell MJ, et al. Treatment of the malignant carcinoid syndrome. Evaluation of a long acting somatostatin analogue. N Engl J Med. 1986;315:663–6.

    Article  CAS  PubMed  Google Scholar 

  13. Vitale G, Carra S, Alessi Y, et al. Carcinoid syndrome preclinical models and future therapeutic strategies. Int J Mol Sci. 2023;24:3610.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan

    Keiko Oda, Tomohiro Murata, Kayo Tsujimoto, Fumika Tanaka, Daisuke Takahashi, Ryosuke Saiki, Yosuke Hirabayashi, Kan Katayama & Kaoru Dohi

  2. Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan

    Akira Tsunoda & Kanako Saito

  3. Department of Pathology, Mie University Graduate School of Medicine, Tsu, Japan

    Hiroto Yuasa & Hiroshi Imai

Authors
  1. Keiko Oda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tomohiro Murata
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kayo Tsujimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fumika Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Daisuke Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ryosuke Saiki
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yosuke Hirabayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Akira Tsunoda
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kanako Saito
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hiroto Yuasa
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Hiroshi Imai
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Kan Katayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Kaoru Dohi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tomohiro Murata.

Ethics declarations

Conflict of interest

The authors have declared that no conflict of interest exists.

Human and animal participation

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from the patient described.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Oda, K., Murata, T., Tsujimoto, K. et al. A case of carcinoid syndrome probably exacerbated by hemodialysis in which prochlorperazine maleate was effective. CEN Case Rep 13, 135–140 (2024). https://doi.org/10.1007/s13730-023-00814-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13730-023-00814-6

Keywords

Search

Navigation