Blockade of the Flush Associated with Metastatic Gastric Carcinoid by Combined Histamine H₁and H₂Receptor Antagonists

Abstract

THE circulating mediator (or mediators) responsible for flushing seen in patients with carcinoid syndrome has remained unidentified. The patient described in this study, a 54-year-old woman with a metastatic gastric carcinoid tumor, has experienced approximately four attacks of flushing a day for the past 22 years, each lasting for approximately 30 minutes to three hours.1 , 2 In 1962 this patient was studied by Oates and Sjoerdsma and found to have markedly elevated levels of urinary free histamine. Administration of L-histidine monohydrochloride markedly increased the frequency, severity and duration of flushes.1 , 2 Despite this evidence that histamine might participate in the flushing attacks, . . .