The Effect of Pyridoxine Deficiency on Carcinoid Syndrome

Case Studies1 November 1966The Effect of Pyridoxine Deficiency on Carcinoid SyndromeStudy of a Case of Metastatic Bronchial Adenoma Treated with Induced Vitamin B6 DeficiencySALMAN GAILANI, M.B., AUGUSTINE L. ROQUE, M.D., JAMES F. HOLLAND, M.D.SALMAN GAILANI, M.B.Search for more papers by this author, AUGUSTINE L. ROQUE, M.D.Search for more papers by this author, JAMES F. HOLLAND, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-65-5-1044 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptCarcinoid syndrome produced by metastatic bronchial adenoma is a rare but a well-established entity (1). Although the role of serotonin in the production of the carcinoid flush has been disputed recently (2, 3), elevated blood serotonin and increased excretion of its metabolite (5-hydroxyindolacetic acid (5-HIAA)) are still the most consistent measurable parameters in this condition. This paper presents the report of a patient with carcinoid syndrome caused by metastatic bronchial adenoma in whom definite symptomatic improvement was achieved by interference with serotonin synthesis. This interference was accomplished by production of a vitamin B6deficiency state during prolonged ingestion of a...References1. FRANKLIEBERTHAL HDMM: Carcinoid syndrome originating in bronchial adenoma. Arch. Intern. Med. (Chicago) 111: 791, 1963. CrossrefMedlineGoogle Scholar2. ROBERTSONPEARTANDREWS JIWSTM: The mechanism of facial flushes in the carcinoid syndrome. Quart. J. Med. 31: 103, 1962. MedlineGoogle Scholar3. LEVINESJOERDSMA RJA: Pressor amines and the carcinoid flush. Ann. Intern. Med. 58: 818, 1963. LinkGoogle Scholar4. PEARSE AG: Histochemistry—Theoretical and Applied, 2nd ed. Little, Brown and Co., Boston, 1960, p. 641. Google Scholar5. GAILANI S: Pyridoxal phosphate determination in isolated leukocytes and tissue by E. coli apotryptophanase. Anal. Biochem. 13: 19, 1965. CrossrefGoogle Scholar6. REDDYREYNOLDSPRICE SKMSJM: The determination of 4-pyridoxic acid in human urine. J. Biol. Chem. 233: 691, 1958. CrossrefMedlineGoogle Scholar7. UDENFRIENDTITUSWEISSBACH SEH: The identification of 5-hydroxy-3-indoleacetic acid in normal urine and a method for its assay. J. Biol. Chem. 216: 499, 1955. CrossrefMedlineGoogle Scholar8. UDENFRIENDWEISSBACHBRODIE SHBB: Assay of serotonin and related metabolites, enzymes and drugs. Meth. Biochem. Anal. 6: 95, 1958. MedlineGoogle Scholar9. DILLARDBRECHERCRONKITE GHGEP: Separation, concentration and transfusion of platelets. Proc. Soc. Exp. Biol. Med. 78: 796, 1951. CrossrefMedlineGoogle Scholar10. VILTERMUELLERGLAZERJARROLDABRAHAMTHOMPSONHAWKINS RWJFHSTJCV: The effect of vitamin B6 deficiency by desoxypyridoxine in human beings. J. Lab. Clin. Med. 42: 335, 1953. MedlineGoogle Scholar11. SPENCER H: Rare pulmonary tumors—bronchial adenomas, in Pathology of the Lung (Excluding Pulmonary Tuberculosis). The Macmillan Co., New York, 1962, p. 683. Google Scholar12. WILLIAMSAZZOPARDI EDJG: Tumors of the lung and the carcinoid syndrome. Thorax 15: 30, 1960. CrossrefMedlineGoogle Scholar13. SJOERDSMAMELMON AKL: Severe flushing reactions responsive to steroid in patients with bronchial carcinoid. Lancet 2: 791, 1964. CrossrefMedlineGoogle Scholar14. UDENFRIEND S: Amino acid decarboxylation steps in the biosynthesis of norepinephrine, serotonin, and histamine. Vitamins Hormones (N. Y.) 22: 445, 1964. CrossrefMedlineGoogle Scholar15. GELLHORNJONES ALO: Pyridoxine deficient diet and desoxypyridoxine in the therapy of lymphosarcoma and acute leukemia in man. Blood 4: 60, 1949. CrossrefMedlineGoogle Scholar16. WEIRMORNINGSTAR DRWA: The effect of pyridoxine deficiency induced by desoxypyridoxine on acute lymphatic leukemia of adults. Blood 9: 173, 1954. CrossrefMedlineGoogle Scholar17. GAILANIHOLLAND SJF: Biochemical and clinical studies of vitamin B6 deficiency in man. Fed. Proc. 24: 314, 1965. Google Scholar18. MENGEL CE: Therapy of the malignant carcinoid syndrome. Ann. Intern. Med. 62: 587, 1965. LinkGoogle Scholar19. SCHRODTDIZONPESKOEHOWELLROBIESTEVENSON GRFYLYRSCHTD: The effect of pyridoxine antagonists in the carcinoid syndrome. Amer. Practit. 11: 750, 1960. Google Scholar20. LUDWIG GD: Inhibition of 5-hydroxyindole acetic acid (5-HIAA) excretion by isonicotinic acid hydrozide (INH) in patients with malignant carcinoid. Clin. Res. 8: 30, 1960. Google Scholar21. DAVISALEXANDERADICOFF RBCSA: Metabolic studies in carcinoid syndrome: observations on use of alpha methyl DOPA isonicotinic acid hydrazide and selective tryptophan deficiency. Metabolism 10: 1035, 1961. MedlineGoogle Scholar22. ROSENMIHICHNICOL FECA: Selective metabolic and chemotherapeutic effects of vitamin B6 antimetabolites. Vitamins Hormones (N. Y.) 22: 609, 1964. CrossrefMedlineGoogle Scholar23. HAVERBACKSTUBRINMAJCHER BJMISJ: Serotonin and related substances. DM p. 8, 1966. Google Scholar24. DAVIS RB: Observations on the occurrence and significance of serotonin in carcinoid tumors. Amer. J. Path. 41: 693, 1962. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Buffalo, New YorkFrom the Departments of Medicine A and Pathology, Roswell Park Memorial Institute, New York State Department of Health, Buffalo, N. Y.This investigation was supported by grant CA05834, the National Cancer Institute, National Institutes of Health, Bethesda, Md.Requests for reprints should be addressed to Salman Gailani, M.B., 666 Elm St., Buffalo, N. Y. 14203. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByEffects of vitamin B6 metabolism on oncogenesis, tumor progression and therapeutic responsesClinical and biochemical studies of pyridoxine deficiency in patients with neoplastic diseases 1 November 1966Volume 65, Issue 5Page: 1044-1050KeywordsAdenomasAttentionDiarrheaDietExcretionIngestionMetabolitesProteinsPyridoxineSerotonin Issue Published: 1 November 1966 PDF DownloadLoading ...