Carcinoid Myopathy and Treatment with Cyproheptadine (Periactin)

Overview

Journal Gut

Specialty Gastroenterology

Date 1974 Jan 1

PMID 4274414

Citations 6

Authors

E M Berry

C Maunder

M Wilson

Affiliations

Soon will be listed here.

Abstract

A case of the carcinoid syndrome associated with a proximal myopathy is reported. Histology showed advanced atrophy of type II muscle fibres but no inflammation. Perinuclear acid phosphatase was increased. Electron microscopy revealed persistence of the Z-line until the muscle fibre had been severely disrupted. Similar lesions have been observed in the hereditary muscular dystrophy in mice, and also in these animals and in rats when injected with 5-hydroxytryptamine (5-HT). Treatment with cyproheptadine caused a documented response in the patient's debilitating diarrhoea and also produced symptomatic improvement in her muscular power. We suggest that the myopathy is due to circulating 5-HT or is a non-metastatic complication of the carcinoid tumour.

Citing Articles

Management of severe arterial hypertension associated with serotonin syndrome: a case report analysis based on systematic review techniques.

Ott M, Mannchen J, Jamshidi F, Werneke U Ther Adv Psychopharmacol. 2019; 9:2045125318818814.

PMID: 30886699 PMC: 6413434. DOI: 10.1177/2045125318818814.

Complications from carcinoid syndrome: review of the current evidence.

Mota J, Sousa L, Riechelmann R Ecancermedicalscience. 2016; 10:662.

PMID: 27594907 PMC: 4990058. DOI: 10.3332/ecancer.2016.662.

Paraneoplastic vasculitic neuropathy related to carcinoid tumor.

Muley S, Brown K, Parry G J Neurol. 2008; 255(7):1085-7.

PMID: 18458858 DOI: 10.1007/s00415-008-0825-7.

Use of somatostatin analog in management of carcinoid syndrome.

Vinik A, Moattari A Dig Dis Sci. 1989; 34(3 Suppl):14S-27S.

PMID: 2920654 DOI: 10.1007/BF01536042.

Myasthenia gravis associated with a hormone producing malignant carcinoid tumour.

Wroe S, Ardron M, Bowden A J Neurol Neurosurg Psychiatry. 1985; 48(7):719-20.

PMID: 2411875 PMC: 1028424. DOI: 10.1136/jnnp.48.7.719.

References

WILKINSON M, Urich H, Croft P . The remote effects of cancer on the nervous system. Proc R Soc Med. 1967; 60(7):683-92. PMC: 2211667. View

OSteen W, Barnard Jr J, Yates R . Morphologic changes in skeletal muscle induced by serotonin treatment: a light- and electron-microscope study. Exp Mol Pathol. 1967; 7(2):145-55. DOI: 10.1016/0014-4800(67)90026-3. View

Thomas D, Vane J . 5-hydroxytryptamine in the circulation of the dog. Nature. 1967; 216(5113):335-8. DOI: 10.1038/216335a0. View

Smith R, Stern G . Myopathy, osteomalacia and hyperparathyroidism. Brain. 1967; 90(3):593-602. DOI: 10.1093/brain/90.3.593. View

Vane J . The release and fate of vaso-active hormones in the circulation. Br J Pharmacol. 1969; 35(2):209-42. PMC: 1703229. DOI: 10.1111/j.1476-5381.1969.tb07982.x. View