Carcinoid syndrome I. What every physician needs to know. The carcinoid syndrome is characterized by symptoms that may include intermittent flushing (90% of patients), diarrhea (70%), abdominal pain (40%), right-sided heart disease (30%), and wheezing (15%). Carcinoid tumors are neuroendocrine tumors of the amine precursor uptake decarboxylase cells (APUD cells) of the gastrointestinal tract, bronchi,…
I. Problem/challenge Many constellations of symptoms and physical exam findings can provoke a suspicion for a connective tissue disease and prompt antinuclear antibody (ANA) testing. A clinical suspicion of systemic rheumatic disease is at times supported by well-characterized features of the patient’s presentation, but at other times an ANA test may be sent when a…
Lupus Nephritis I. What every physician needs to know. Lupus nephritis is a common complication of Systemic Lupus Erythematosus (SLE). Upwards of 50-60% of all lupus patients will develop renal involvement and if not recognized and treated promptly it can lead to end stage renal disease requiring dialysis. It is important to keep in mind…
