Anaphylaxis differential diagnosis: Difference between revisions

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* [[Systemic Mastocytosis]]
* [[Systemic Mastocytosis]]
* [[Vagal]] reactions
* [[Vagal]] reactions
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! colspan="2" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
| colspan="9" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
|
|
|
! colspan="10" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
| colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
|-
| colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
|
|
|
! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
!
!
!
|-
!
!
!
!
!
!
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! colspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
!
!
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Abdominal pain]]
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Diarrhea]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Flushing]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Dyspnea]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Palpitations]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other symptoms
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Wheezing]]
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Telangiectasia]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Hypotension]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Tachycardia]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Systolic murmurs|Systolic murmur]] of [[tricuspid regurgitation]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other physical findings
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Urinary 5-hydroxyindoleacetic acid (5-HIAA)
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum [[Chromogranin]] A (CgA)
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other markers
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Computed tomography|Abdominal computed tomography]] (CT)
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Mri|Abdominal MRI]]
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Somatostatin receptor scintigraphy [SRS], or Octreoscan
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Metaiodobenzylguanidine (MIBG) scintigraphy
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other diagnostic studies
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Transthoracic echocardiography
|-
| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |Carcinoid Syndrome<ref name="pmid30133565">{{cite journal |vauthors=Rubin de Celis Ferrari AC, Glasberg J, Riechelmann RP |title=Carcinoid syndrome: update on the pathophysiology and treatment |journal=Clinics (Sao Paulo) |volume=73 |issue=suppl 1 |pages=e490s |date=August 2018 |pmid=30133565 |pmc=6096975 |doi=10.6061/clinics/2018/e490s |url=}}</ref><ref name="pmid14693013">{{cite journal |vauthors=Hegyi J, Schwartz RA, Hegyi V |title=Pellagra: dermatitis, dementia, and diarrhea |journal=Int. J. Dermatol. |volume=43 |issue=1 |pages=1–5 |date=January 2004 |pmid=14693013 |doi= |url=}}</ref><ref name="pmid15100502">{{cite journal |vauthors=Savelli G, Lucignani G, Seregni E, Marchianò A, Serafini G, Aliberti G, Villano C, Maccauro M, Bombardieri E |title=Feasibility of somatostatin receptor scintigraphy in the detection of occult primary gastro-entero-pancreatic (GEP) neuroendocrine tumours |journal=Nucl Med Commun |volume=25 |issue=5 |pages=445–9 |date=May 2004 |pmid=15100502 |doi= |url=}}</ref><ref name="pmid151005022">{{cite journal |vauthors=Savelli G, Lucignani G, Seregni E, Marchianò A, Serafini G, Aliberti G, Villano C, Maccauro M, Bombardieri E |title=Feasibility of somatostatin receptor scintigraphy in the detection of occult primary gastro-entero-pancreatic (GEP) neuroendocrine tumours |journal=Nucl Med Commun |volume=25 |issue=5 |pages=445–9 |date=May 2004 |pmid=15100502 |doi= |url=}}</ref><ref name="BoraVithiavathi2012">{{cite journal|last1=Bora|first1=ManashKumar|last2=Vithiavathi|first2=S|title=Primary bronchial carcinoid: A rare differential diagnosis of pulmonary koch in young adult patient|journal=Lung India|volume=29|issue=1|year=2012|pages=59|issn=0970-2113|doi=10.4103/0970-2113.92366}}</ref><ref name="pmid25207053">{{cite journal |vauthors=Yazıcıoğlu A, Yekeler E, Bıcakcıoğlu P, Ozaydın E, Karaoğlanoğlu N |title=Synchronous bilateral multiple typical pulmonary carcinoid tumors: a unique case with 10 typical carcinoids |journal=Balkan Med J |volume=29 |issue=4 |pages=450–2 |date=December 2012 |pmid=25207053 |pmc=4115868 |doi=10.5152/balkanmedj.2012.081 |url=}}</ref><ref name="pmid14616879">{{cite journal |vauthors=Krausz Y, Keidar Z, Kogan I, Even-Sapir E, Bar-Shalom R, Engel A, Rubinstein R, Sachs J, Bocher M, Agranovicz S, Chisin R, Israel O |title=SPECT/CT hybrid imaging with 111In-pentetreotide in assessment of neuroendocrine tumours |journal=Clin. Endocrinol. (Oxf) |volume=59 |issue=5 |pages=565–73 |date=November 2003 |pmid=14616879 |doi= |url=}}</ref><ref name="van der LelyHerder2005">{{cite journal|last1=van der Lely|first1=Aart J.|last2=Herder|first2=Wouter W. de|title=Carcinoid syndrome: diagnosis and medical management|journal=Arquivos Brasileiros de Endocrinologia & Metabologia|volume=49|issue=5|year=2005|pages=850–860|issn=0004-2730|doi=10.1590/S0004-27302005000500028}}</ref><ref name="pmid28238592">{{cite journal |vauthors=Halperin DM, Shen C, Dasari A, Xu Y, Chu Y, Zhou S, Shih YT, Yao JC |title=Frequency of carcinoid syndrome at neuroendocrine tumour diagnosis: a population-based study |journal=Lancet Oncol. |volume=18 |issue=4 |pages=525–534 |date=April 2017 |pmid=28238592 |pmc=6066284 |doi=10.1016/S1470-2045(17)30110-9 |url=}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Neuroendocrine tumor]] of [[midgut]] <ref name="pmid3227292">{{cite journal |vauthors=Sjöblom SM |title=Clinical presentation and prognosis of gastrointestinal carcinoid tumours |journal=Scand. J. Gastroenterol. |volume=23 |issue=7 |pages=779–87 |date=September 1988 |pmid=3227292 |doi= |url=}}</ref><ref name="pmid24059366">{{cite journal |vauthors=Ganeshan D, Bhosale P, Yang T, Kundra V |title=Imaging features of carcinoid tumors of the gastrointestinal tract |journal=AJR Am J Roentgenol |volume=201 |issue=4 |pages=773–86 |date=October 2013 |pmid=24059366 |doi=10.2214/AJR.12.9758 |url=}}</ref><ref name="symptoms">Signs and symptoms of carcinoid syndrome. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/patient/gi-carcinoid-treatment-pdq</ref><ref name="pmid15887161">{{cite journal |vauthors=Modlin IM, Kidd M, Latich I, Zikusoka MN, Shapiro MD |title=Current status of gastrointestinal carcinoids |journal=Gastroenterology |volume=128 |issue=6 |pages=1717–51 |date=May 2005 |pmid=15887161 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +
Mild
| style="background: #F5F5F5; padding: 5px;" | +
* Intermittent
* Secretory [[diarrhea]]
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
* [[Pellagra]]
[[Dermatitis]]
[[Diarrhea]]
[[Dementia]]
[[Metastatic]] [[tumors]] in the [[Liver (2)|liver]]: [[Right upper quadrant]] pain, [[Hepatomegaly (new)|hepatomegaly]], and early [[satiety]]
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
* [[NT-proBNP]]
** [[Screening]] of [[Carcinoid disease|carcinoid heart disease]]
** Blood [[Serotonin]] levels
| style="background: #F5F5F5; padding: 5px;" |
* [[Neuroendocrine tumor]] of [[midgut]] are difficult to identify on [[CT]] because of their small size.
* Findings: [[Mass|mass-]]<nowiki/>like process with soft tissue "spokes" radiating into the [[mesenteric]] [[fat]] toward the [[small bowel]] causing retraction.
* [[Liver]] [[metastases]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Sensitivity|Sensitive]] for detection of [[Liver (2)|liver]] [[metastases]]
| style="background: #F5F5F5; padding: 5px;" | +
* Localization of [[carcinoid tumor]]
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
* 68-Ga DOTATATE [[PET scan]]
* [[Positron emission tomography-computed tomography]] ([[PET-CT]]) using 18[[-fluoro-dihydroxyphenylalanine]]
* Ki-67 labeling index
* [[Endoscopy]] for [[metastatic]] [[Neuroendocrine tumour]] with an unknown primary site.
|
* Valve thickening with retraction and reduction in the mobility of the [[Tricuspid valves|tricuspid valve]]
*
| style="background: #F5F5F5; padding: 5px;" |
* [[Enterochromaffin cells|Enterochromaffin]] [[cells]] stain with [[Potassium chromate|potassium chromate (chromaffin]]).
*On [[electron microscopy]] ,the [[cells]] in [[tumors]] are found to contain [[membrane]]-bound [[Granules|secretory granules]] with dense-core [[granules]] in the [[cytoplasm]].
| style="background: #F5F5F5; padding: 5px;" |
* Somatostatin receptor scintigraphy [SRS], or [[Octreoscan]]
* [[Biopsy]] and [[histopathology]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Mesenteric]] [[fibrosis]]
Pathognomonic radiological sign of [[midgut]] [[Neuroendocrine tumor|NET]].
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Neuroendocrine tumor]] of [[lung]]<ref name="pmid18473355">{{cite journal |vauthors=Gustafsson BI, Kidd M, Chan A, Malfertheiner MV, Modlin IM |title=Bronchopulmonary neuroendocrine tumors |journal=Cancer |volume=113 |issue=1 |pages=5–21 |date=July 2008 |pmid=18473355 |doi=10.1002/cncr.23542 |url=}}</ref><ref name="JeungGasser2002">{{cite journal|last1=Jeung|first1=Mi-Young|last2=Gasser|first2=Bernard|last3=Gangi|first3=Afshin|last4=Charneau|first4=Dominique|last5=Ducroq|first5=Xavier|last6=Kessler|first6=Romain|last7=Quoix|first7=Elisabeth|last8=Roy|first8=Catherine|title=Bronchial Carcinoid Tumors of the Thorax: Spectrum of Radiologic Findings|journal=RadioGraphics|volume=22|issue=2|year=2002|pages=351–365|issn=0271-5333|doi=10.1148/radiographics.22.2.g02mr01351}}</ref><ref name="pmid1649924">{{cite journal |vauthors=Nessi R, Basso Ricci P, Basso Ricci S, Bosco M, Blanc M, Uslenghi C |title=Bronchial carcinoid tumors: radiologic observations in 49 cases |journal=J Thorac Imaging |volume=6 |issue=2 |pages=47–53 |date=April 1991 |pmid=1649924 |doi= |url=}}</ref><ref name="pmid5831899">{{cite journal |vauthors=Melmon KL, Sjoerdsma A, Mason DT |title=Distinctive clinical and therapeutic aspects of the syndrome associated with bronchial carcinoid tumors |journal=Am. J. Med. |volume=39 |issue=4 |pages=568–81 |date=October 1965 |pmid=5831899 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
* [[Cough]]
* [[Hemoptysis]]
* [[Chest pain]]
* [[Fever]] due to [[Pneumonia|post -obstructuve pneuomnia]]
*
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
* [[Immunohistochemical  stains]]:
* [[Synaptophysin]]
* [[Neuron-specific enolase]]
* [[NT-proBNP]]
* Low [[serotonin]] content as compared to [[midgut]] [[Tumors|tumors.]]
| style="background: #F5F5F5; padding: 5px;" |
* Atypical [[neuroendocrine tumors]] have a greater tendency to [[metastasize]] to [[Liver|liver,]][[hypervascular]], and becomies isodense relative to th[[Liver|e liver]] [[parenchyma]] after [[contrast]] administration.
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |[[Sensitivity (tests)|Sensitive]] for detection o[[Liver (2)|f liver]] [[metastases]] if present
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
* [[Chest X ray]]: round or oval [[Opacity|opacities]] from 2-5cm with sharp and notched margins
* [[Chest]] [[CT]] : [[Hilar]] or Perihilar Masses, Endobronchial [[Nodules]],Related to [[Bronchial|bronchial Obstruction]]:peripheral [[atelectasis]] and postobstructive [[pneumonia]]
* [[PFTs|Pulmonary funcation test]]
* [[Bronchoscopy]]
* [[68-Ga DOTATATE PET scan]]
* Fluorodeoxyglucose [[PET scan|PET scans]] for atypical [[lung]] [[Neuroendocrine|NETs]] .
| -
| style="background: #F5F5F5; padding: 5px;" |Typical low-grade:bland cells containing regular round [[nuclei]] with finely dispersed [[chromatin]] and inconspicuous small [[nucleoli]].Mitotic figures are scarce and [[necrosis]] is absent.
Intermediate-grade atypical: presence of [[Neuroendocrine]] morphology and either [[necrosis]] or 2 to 10 [[mitoses]] per 10 HPF
|
* [[Biopsy]] and [[histopathology]]
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Irritable Bowel Syndrome]]<ref name="pmid18371141">{{cite journal |vauthors=Ford AC, Forman D, Bailey AG, Axon AT, Moayyedi P |title=Irritable bowel syndrome: a 10-yr natural history of symptoms and factors that influence consultation behavior |journal=Am. J. Gastroenterol. |volume=103 |issue=5 |pages=1229–39; quiz 1240 |date=May 2008 |pmid=18371141 |doi=10.1111/j.1572-0241.2007.01740.x |url=}}</ref><ref name="pmid28374308">{{cite journal |vauthors=Simren M, Palsson OS, Whitehead WE |title=Update on Rome IV Criteria for Colorectal Disorders: Implications for Clinical Practice |journal=Curr Gastroenterol Rep |volume=19 |issue=4 |pages=15 |date=April 2017 |pmid=28374308 |pmc=5378729 |doi=10.1007/s11894-017-0554-0 |url=}}</ref><ref name="pmid12454865">{{cite journal |vauthors= |title=American Gastroenterological Association medical position statement: irritable bowel syndrome |journal=Gastroenterology |volume=123 |issue=6 |pages=2105–7 |date=December 2002 |pmid=12454865 |doi=10.1053/gast.2002.37095b |url=}}</ref><ref name="pmid27144627">{{cite journal |vauthors=Mearin F, Lacy BE, Chang L, Chey WD, Lembo AJ, Simren M, Spiller R |title=Bowel Disorders |journal=Gastroenterology |volume= |issue= |pages= |date=February 2016 |pmid=27144627 |doi=10.1053/j.gastro.2016.02.031 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +
Perioidic
| style="background: #F5F5F5; padding: 5px;" |
* Intermittent
* Chronic history of [[Diarrhea|diarhea]] alternating with [[constipation]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
*
* [[Fibromyalgia]]
* [[Chronic fatigue syndrome]]
* [[Gastroesophageal reflux disease]],
* [[Functional dyspepsia]]
* [[Non-cardiac chest pain]],
* [[Major depression]]
* ,[[Anxiety Disorder|Anxiety]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
|
* [[Bristol stool]] form scale should to record [[stool]] consistency
* [[Abdominal|Abdomina]]<nowiki/>l [[Radiographic|radiograph]] to assess for [[Stool|stoo]]<nowiki/>l accumulation and determine the severity.
* Age-appropriate [[colorectal cancer]] [[screening]] in all [[patients]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |[[Rome IV criteria]]
* Recurrent [[abdominal pain]],  at least 1day/week in the last 3 months, a/s with 2 or more of the following criteria:
•Related to [[defecation]]
•Associated with a change in [[stool]] frequency
•Associated with a change in [[stool]] form (appearance)
| style="background: #F5F5F5; padding: 5px;" |
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Small intestine cancer|Malignant neoplasms of small intestine]]<ref name="pmid23789703">{{cite journal |vauthors=McLaughlin PD, Maher MM |title=Primary malignant diseases of the small intestine |journal=AJR Am J Roentgenol |volume=201 |issue=1 |pages=W9–14 |date=July 2013 |pmid=23789703 |doi=10.2214/AJR.12.8492 |url=}}</ref><ref name="pmid17372046">{{cite journal |vauthors=Hatzaras I, Palesty JA, Abir F, Sullivan P, Kozol RA, Dudrick SJ, Longo WE |title=Small-bowel tumors: epidemiologic and clinical characteristics of 1260 cases from the connecticut tumor registry |journal=Arch Surg |volume=142 |issue=3 |pages=229–35 |date=March 2007 |pmid=17372046 |doi=10.1001/archsurg.142.3.229 |url=}}</ref><ref name="pmid17026561">{{cite journal |vauthors=Lepage C, Bouvier AM, Manfredi S, Dancourt V, Faivre J |title=Incidence and management of primary malignant small bowel cancers: a well-defined French population study |journal=Am. J. Gastroenterol. |volume=101 |issue=12 |pages=2826–32 |date=December 2006 |pmid=17026561 |doi=10.1111/j.1572-0241.2006.00854.x |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" |
* [[Constipation]]
* [[Fatigue]]
* Early [[satiety]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |* [[Abdominal mass]]
* [[Ascites]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |[[Abdominal]] [[CT scan]] may be diagnostic of [[Small intestine cancer|small intestine cancer.]] Findings on [[CT scan]] suggestive of [[Small intestine cancer CT|small intestine cancer]] include intrinsic [[mass]] with a short segment of [[Bowel|bowel wall]] thickening
| style="background: #F5F5F5; padding: 5px;" |[[MRI]] and [[MRI enteroscopy]] are other advance modalities to [[diagnose]] and [[Staging (pathology)|stage]] [[Small intestine cancer|small intestinal cancers]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |[[Endoscopy|Enteroscopy]], [[capsule endoscopy]] and double balloon [[enteroscopy]]
|
| style="background: #F5F5F5; padding: 5px;" |
*[[Adenocarcinoma|Adenocarcinomas]] may be polypoid, infiltrating, or as annular constricting lesions is [[small intestine]].
*[[Polyps]] and [[adenomas]] of [[small intestine]] are considered precursor lesions of [[adenocarcinoma]].
*[[Lymphoma|Lymphomas]] of [[small intestine]] present with suspicious growths in [[submucosa]] with normal appearing [[muscosa]].
*[[Endoscopy|Endoscopic]] evaluation may show multifocal involvement and large [[biopsies]] are required for diagnoses
|[[Biopsy]] and [[histopathology]]
|
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Crohn disease]]<ref name="pmid18649092">{{cite journal |vauthors=Hara AK, Swartz PG |title=CT enterography of Crohn's disease |journal=Abdom Imaging |volume=34 |issue=3 |pages=289–95 |date=2009 |pmid=18649092 |doi=10.1007/s00261-008-9443-1 |url=}}</ref><ref name="BaumgartSandborn2012">{{cite journal|last1=Baumgart|first1=Daniel C|last2=Sandborn|first2=William J|title=Crohn's disease|journal=The Lancet|volume=380|issue=9853|year=2012|pages=1590–1605|issn=01406736|doi=10.1016/S0140-6736(12)60026-9}}</ref><ref name="FeuersteinCheifetz2017">{{cite journal|last1=Feuerstein|first1=Joseph D.|last2=Cheifetz|first2=Adam S.|title=Crohn Disease: Epidemiology, Diagnosis, and Management|journal=Mayo Clinic Proceedings|volume=92|issue=7|year=2017|pages=1088–1103|issn=00256196|doi=10.1016/j.mayocp.2017.04.010}}</ref><ref name="García-BoschOrdás2016">{{cite journal|last1=García-Bosch|first1=O.|last2=Ordás|first2=I.|last3=Aceituno|first3=M.|last4=Rodríguez|first4=S.|last5=Ramírez|first5=A. M.|last6=Gallego|first6=M.|last7=Ricart|first7=E.|last8=Rimola|first8=J.|last9=Panes|first9=J.|title=Comparison of Diagnostic Accuracy and Impact of Magnetic Resonance Imaging and Colonoscopy for the Management of Crohn’s Disease|journal=Journal of Crohn's and Colitis|volume=10|issue=6|year=2016|pages=663–669|issn=1873-9946|doi=10.1093/ecco-jcc/jjw015}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
* [[Right lower quadrant abdominal pain resident survival guide|Right lower quadrant]] [[pain]]
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* Gross [[bloody diarrhea]] +/-
* [[Weight loss]]
* [[Fatigue (physical)|Fatigue]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
*
* [[Weight loss]]
* [[Pallor]]
* [[Oral lesions]]
* [[Odynophagia]]
* [[Dysphagia]]
* Perianal skin tags
* [[Sinus tracts]]
* [[Gallstones]]
* Extraintestinal manifestations
* [[Arthritis]]
* [[Uveitis]], [[Iritis]], and [[Episcleritis]]
* [[Erythema nodosum]] and [[Pyoderma gangrenosum]]
* [[Primary sclerosing cholangitis]]
* Secondary [[amyloidosis]]
* [[Thromboembolism]]
* [[Renal stones]]
* [[Osteoporosis]]
* [[Vitamin B12 deficiency]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* [[CRP]]  may be high
* [[p-ANCA]] and [[Anti saccharomyces cerevisiae antibodies|ASCA]]
*
| style="background: #F5F5F5; padding: 5px;" |
* CT enterography [[:Small bowel]] [[inflammation]] by displaying mural hyperenhancement and thickening; engorged [[vasa recta]]; and [[perienteric]] [[inflammatory]] changes.
|
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
|
* [[CBC]]
* [[Blood chemistry tests|Blood chemistry]] including [[Electrolyte|electrolytes]]
* [[Kidney function|Renal function tests]]
* [[liver enzymes]]
* [[Blood glucose]]
* [[ESR]]
* [[CRP]]
* [[Serum iron]]
* [[Vitamin D]] & [[vitamin B12 levels]]
* [[Stool D/R]] and [[Culture media|culture]] for [[ova]] and [[parasites]],
* [[Clostridium difficile|''C. difficile'' toxin]]
|<nowiki>-</nowiki>
| style="background: #F5F5F5; padding: 5px;" |
* Focal ulcerations and acute and chronic inflammation
* [[Granulomas]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Colonoscopic|Colonoscop]]<nowiki/>y:focal ulcerations adjacent to areas of normal appearing [[mucosa]] along with polypoid mucosa[[Skip lesion|l,skip lesion]]<nowiki/>s,[[pseudopolyps]],
| style="background: #F5F5F5; padding: 5px;" |
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Benign cutaneous flushing]]<ref name="IziksonEnglish2006">{{cite journal|last1=Izikson|first1=Leonid|last2=English|first2=Joseph C.|last3=Zirwas|first3=Matthew J.|title=The flushing patient: Differential diagnosis, workup, and treatment|journal=Journal of the American Academy of Dermatology|volume=55|issue=2|year=2006|pages=193–208|issn=01909622|doi=10.1016/j.jaad.2005.07.057}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
|
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mastocytosis|Systemic mastocytosis]]<ref name="HartmannEscribano2016">{{cite journal|last1=Hartmann|first1=Karin|last2=Escribano|first2=Luis|last3=Grattan|first3=Clive|last4=Brockow|first4=Knut|last5=Carter|first5=Melody C.|last6=Alvarez-Twose|first6=Ivan|last7=Matito|first7=Almudena|last8=Broesby-Olsen|first8=Sigurd|last9=Siebenhaar|first9=Frank|last10=Lange|first10=Magdalena|last11=Niedoszytko|first11=Marek|last12=Castells|first12=Mariana|last13=Oude Elberink|first13=Joanna N.G.|last14=Bonadonna|first14=Patrizia|last15=Zanotti|first15=Roberta|last16=Hornick|first16=Jason L.|last17=Torrelo|first17=Antonio|last18=Grabbe|first18=Jürgen|last19=Rabenhorst|first19=Anja|last20=Nedoszytko|first20=Boguslaw|last21=Butterfield|first21=Joseph H.|last22=Gotlib|first22=Jason|last23=Reiter|first23=Andreas|last24=Radia|first24=Deepti|last25=Hermine|first25=Olivier|last26=Sotlar|first26=Karl|last27=George|first27=Tracy I.|last28=Kristensen|first28=Thomas K.|last29=Kluin-Nelemans|first29=Hanneke C.|last30=Yavuz|first30=Selim|last31=Hägglund|first31=Hans|last32=Sperr|first32=Wolfgang R.|last33=Schwartz|first33=Lawrence B.|last34=Triggiani|first34=Massimo|last35=Maurer|first35=Marcus|last36=Nilsson|first36=Gunnar|last37=Horny|first37=Hans-Peter|last38=Arock|first38=Michel|last39=Orfao|first39=Alberto|last40=Metcalfe|first40=Dean D.|last41=Akin|first41=Cem|last42=Valent|first42=Peter|title=Cutaneous manifestations in patients with mastocytosis: Consensus report of the European Competence Network on Mastocytosis; the American Academy of Allergy, Asthma & Immunology; and the European Academy of Allergology and Clinical Immunology|journal=Journal of Allergy and Clinical Immunology|volume=137|issue=1|year=2016|pages=35–45|issn=00916749|doi=10.1016/j.jaci.2015.08.034}}</ref><ref name="LeeWhittaker2008">{{cite journal|last1=Lee|first1=Jason K|last2=Whittaker|first2=Scott J|last3=Enns|first3=Robert A|last4=Zetler|first4=Peter|title=Gastrointestinal manifestations of systemic mastocytosis|journal=World Journal of Gastroenterology|volume=14|issue=45|year=2008|pages=7005|issn=1007-9327|doi=10.3748/wjg.14.7005}}</ref><ref name="pmid2002264">{{cite journal |vauthors=Horan RF, Austen KF |title=Systemic mastocytosis: retrospective review of a decade's clinical experience at the Brigham and Women's Hospital |journal=J. Invest. Dermatol. |volume=96 |issue=3 |pages=5S–13S; discussion 13S–14S |date=March 1991 |pmid=2002264 |doi= |url=}}</ref><ref name="SokolGeorgin-Lavialle2010">{{cite journal|last1=Sokol|first1=Harry|last2=Georgin-Lavialle|first2=Sophie|last3=Grandpeix-Guyodo|first3=Catherine|last4=Canioni|first4=Danielle|last5=Barete|first5=Stéphane|last6=Dubreuil|first6=Patrice|last7=Lortholary|first7=Olivier|last8=Beaugerie|first8=Laurent|last9=Hermine|first9=Olivier|title=Gastrointestinal involvement and manifestations in systemic mastocytosis|journal=Inflammatory Bowel Diseases|volume=16|issue=7|year=2010|pages=1247–1253|issn=1078-0998|doi=10.1002/ibd.21218}}</ref><ref name="pmid17063092">{{cite journal |vauthors=Bedeir A, Jukic DM, Wang L, Mullady DK, Regueiro M, Krasinskas AM |title=Systemic mastocytosis mimicking inflammatory bowel disease: A case report and discussion of gastrointestinal pathology in systemic mastocytosis |journal=Am. J. Surg. Pathol. |volume=30 |issue=11 |pages=1478–82 |date=November 2006 |pmid=17063092 |doi=10.1097/01.pas.0000213310.51553.d7 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* [[Maculopapular rash]]
* [[Pruritus]]
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* Diffuse [[musculoskeletal pain]]
* [[Neuropsychiatric symptoms]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* Activating [[mutations]] of ''[[KIT]]''
* Serum [[Tryptase]] levels
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Asthma]] exacerbation<ref name="pmid22386508">{{cite journal |vauthors=Fuhlbrigge A, Peden D, Apter AJ, Boushey HA, Camargo CA, Gern J, Heymann PW, Martinez FD, Mauger D, Teague WG, Blaisdell C |title=Asthma outcomes: exacerbations |journal=J. Allergy Clin. Immunol. |volume=129 |issue=3 Suppl |pages=S34–48 |date=March 2012 |pmid=22386508 |pmc=3595577 |doi=10.1016/j.jaci.2011.12.983 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -<ref name="pmid19187331">{{cite journal |vauthors=Dougherty RH, Fahy JV |title=Acute exacerbations of asthma: epidemiology, biology and the exacerbation-prone phenotype |journal=Clin. Exp. Allergy |volume=39 |issue=2 |pages=193–202 |date=February 2009 |pmid=19187331 |pmc=2730743 |doi=10.1111/j.1365-2222.2008.03157.x |url=}}</ref><ref name="pmid17468458">{{cite journal |vauthors=Aldington S, Beasley R |title=Asthma exacerbations. 5: assessment and management of severe asthma in adults in hospital |journal=Thorax |volume=62 |issue=5 |pages=447–58 |date=May 2007 |pmid=17468458 |pmc=2117186 |doi=10.1136/thx.2005.045203 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|[[Chest X ray]]
|
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Anaphylaxis]]<ref name="pmid18596587">{{cite journal |vauthors=Peavy RD, Metcalfe DD |title=Understanding the mechanisms of anaphylaxis |journal=Curr Opin Allergy Clin Immunol |volume=8 |issue=4 |pages=310–5 |date=August 2008 |pmid=18596587 |pmc=2683407 |doi=10.1097/ACI.0b013e3283036a90 |url=}}</ref><ref name="pmid20944042">{{cite journal |vauthors=Tupper J, Visser S |title=Anaphylaxis: A review and update |journal=Can Fam Physician |volume=56 |issue=10 |pages=1009–11 |date=October 2010 |pmid=20944042 |pmc=2954079 |doi= |url=}}</ref><ref name="pmid12209078">{{cite journal |vauthors=Kemp SF, Lockey RF |title=Anaphylaxis: a review of causes and mechanisms |journal=J. Allergy Clin. Immunol. |volume=110 |issue=3 |pages=341–8 |date=September 2002 |pmid=12209078 |doi= |url=}}</ref><ref name="pmid21293765">{{cite journal |vauthors=Bjornsson HM, Graffeo CS |title=Improving diagnostic accuracy of anaphylaxis in the acute care setting |journal=West J Emerg Med |volume=11 |issue=5 |pages=456–61 |date=December 2010 |pmid=21293765 |pmc=3027438 |doi= |url=}}</ref><ref name="urlUsefulness and Limitations of Sequential Serum Tryptase for the Diagnosis of Anaphylaxis in 102 Patients - FullText - International Archives of Allergy and Immunology 2013, Vol. 160, No. 2 - Karger Publishers">{{cite web |url=https://www.karger.com/Article/Fulltext/339749 |title=Usefulness and Limitations of Sequential Serum Tryptase for the Diagnosis of Anaphylaxis in 102 Patients - FullText - International Archives of Allergy and Immunology 2013, Vol. 160, No. 2 - Karger Publishers |format= |work= |accessdate=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -/+
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
* [[Vomiting]]
* [[Hives|Generalized hives]],
* [[Pruritus]]
* [[Itching]]
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* Swollen [[lips]]-[[tongue]]-[[uvula]]
* [[Periorbital edema]],
* [[Conjunctival|Conjunctival swelling]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* plasma [[tryptase]]
* Plasm[[Histamine|a histamine]] levels
* Take proper clinical history and medication history specially [[beta blockers]],[[Angiotensin Converting Enzyme Inhibitor|ACE-inhibitors,]][[opioids]]
* [[Skin testing]] with [[Allergens|allergen extracts]]
* [[Enzyme linked immunosorbent assay (ELISA)|enzyme-linked immunosorbent assays (ELISAs)]] for quantification of allergen-specific [[IgE]] levels
*
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
|History of exposure to [[Insect allergy|insect]] stings,food alllergy,rubber latex,food [[Additives|additives,]],allergy to medications,physical factors such s excercise and cold
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |Histaminergic [[Angioedema]]<ref name="pmid28687103">{{cite journal |vauthors=Busse PJ, Smith T |title=Histaminergic Angioedema |journal=Immunol Allergy Clin North Am |volume=37 |issue=3 |pages=467–481 |date=August 2017 |pmid=28687103 |doi=10.1016/j.iac.2017.03.001 |url=}}</ref><ref name="pmid28818177">{{cite journal |vauthors=Hahn J, Hoffmann TK, Bock B, Nordmann-Kleiner M, Trainotti S, Greve J |title=Angioedema |journal=Dtsch Arztebl Int |volume=114 |issue=29-30 |pages=489–496 |date=July 2017 |pmid=28818177 |pmc=5569554 |doi=10.3238/arztebl.2017.0489 |url=}}</ref><ref name="pmid28405953">{{cite journal |vauthors=Bernstein JA, Cremonesi P, Hoffmann TK, Hollingsworth J |title=Angioedema in the emergency department: a practical guide to differential diagnosis and management |journal=Int J Emerg Med |volume=10 |issue=1 |pages=15 |date=December 2017 |pmid=28405953 |pmc=5389952 |doi=10.1186/s12245-017-0141-z |url=}}</ref><ref name="pmid23131076">{{cite journal |vauthors=Bernstein JA, Moellman J |title=Emerging concepts in the diagnosis and treatment of patients with undifferentiated angioedema |journal=Int J Emerg Med |volume=5 |issue=1 |pages=39 |date=November 2012 |pmid=23131076 |pmc=3518251 |doi=10.1186/1865-1380-5-39 |url=}}</ref><ref name="pmid23282406">{{cite journal |vauthors=Kaplan AP |title=Angioedema |journal=World Allergy Organ J |volume=1 |issue=6 |pages=103–13 |date=June 2008 |pmid=23282406 |pmc=3651192 |doi=10.1097/WOX.0b013e31817aecbe |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
* Generalized [[pruritus]]
* [[Throat]] tightness
* [[Hoarse voice]]
* [[Difficulty swallowing]]
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* [[Urticaria]]
* Localized [[swelling]] of [[skin]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* [[Bowel|Bowel wall]] edema
* Circumferential thickening of the [[Small bowel|small bowel wall]] with [[ascites]] or incomplete [[obstruction]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* [[CBC|CBC with differential,]]
* [[Electrolyte|Electrolytes]]
* [[Liver function tests]]
* [[C-reactive protein (CRP)|C-reactive protein]]
* [[ESR|Erythrocyte sedimentation rate]]
* Levels of the [[Complement System|complement protein C4]]
* Serum tota[[Tryptase|l tryptase]]
* Allergen-specific [[IgE immunoassay|IgE immunoassays]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* Take proper clinical history of previous similar episodes
* Medication history
* Any allergy to insects stings , foods or any ingestion within previous 24 hours
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Medullary carcinoma of thyroid|Medullary Thyroid Carcinoma]]<ref name="pmid20627492">{{cite journal |vauthors=Pacini F, Castagna MG, Cipri C, Schlumberger M |title=Medullary thyroid carcinoma |journal=Clin Oncol (R Coll Radiol) |volume=22 |issue=6 |pages=475–85 |date=August 2010 |pmid=20627492 |doi=10.1016/j.clon.2010.05.002 |url=}}</ref><ref name="pmid24037980">{{cite journal |vauthors=Roy M, Chen H, Sippel RS |title=Current understanding and management of medullary thyroid cancer |journal=Oncologist |volume=18 |issue=10 |pages=1093–100 |date=2013 |pmid=24037980 |pmc=3805151 |doi=10.1634/theoncologist.2013-0053 |url=}}</ref><ref name="pmid24552221">{{cite journal |vauthors=Mian C, Perrino M, Colombo C, Cavedon E, Pennelli G, Ferrero S, De Leo S, Sarais C, Cacciatore C, Manfredi GI, Verga U, Iacobone M, De Pasquale L, Pelizzo MR, Vicentini L, Persani L, Fugazzola L |title=Refining calcium test for the diagnosis of medullary thyroid cancer: cutoffs, procedures, and safety |journal=J. Clin. Endocrinol. Metab. |volume=99 |issue=5 |pages=1656–64 |date=May 2014 |pmid=24552221 |doi=10.1210/jc.2013-4088 |url=}}</ref><ref name="pmid26494386">{{cite journal |vauthors=Bae YJ, Schaab M, Kratzsch J |title=Calcitonin as Biomarker for the Medullary Thyroid Carcinoma |journal=Recent Results Cancer Res. |volume=204 |issue= |pages=117–37 |date=2015 |pmid=26494386 |doi=10.1007/978-3-319-22542-5_5 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* [[Neck pain]]
* [[Hoarseness]]
* [[Cough]]
* [[Difficulty swallowing]]
* [[Difficulty breathing]]
* [[Lethargy]]
* [[Bone pain]] from [[metastasis]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* [[Solitary thyroid nodule]]
* [[Cervical lymph nodes|Cervical lymph node involvement]]
* [[Weight loss]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* Basal serum [[calcitonin]] concentrations
* [[Carcinoembryonic antigen peptide-1|Carcinoembryonic antigen (CEA) concentration]]
* [[Thyroid function tests]]: normal
* [[Germline]] ''[[RET gene|RET]]'' testing
* [[Calcium|Serum calcium]]
* Plasma fractionated [[Metanephrine|metanephrines]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* [[Ultrasonography]] of the [[neck]]
Fo[[Metastasis|r metastasis]]
* [[Chest]] [[computed tomography]]
* [[Neck]] [[CT]]
* Three-phase contrast-enhanced [[Liver (2)|liver]] [[CT-scans|CT]]
* Axial [[MRI]]
* Bone [[scintigraphy]].
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* [[Immunohistochemical staining]] for [[calcitonin]]
* [[Spindle cells|Spindle]]-shaped and frequently [[Pleomorphic|pleomorphic cells]] without follicle development
| style="background: #F5F5F5; padding: 5px;" |
* [[Fine-needle aspiration|Fine-needle aspiration (FNA) biopsy]]
* [[TNM staging system|TNM staging]]
* American Thyroid Association (ATA) Guidelines for Management and evaluation of [[Medullary carcinoma of the thyroid|Medullary Thyroid Cancer]]
|
|}


==References==
==References==

Revision as of 18:40, 13 May 2019

Anaphylaxis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Differentiating Anaphylaxis from other Diseases

Pseudoanaphylactic Reactions (Conditions that Mimic Anaphylaxis)

First administration of the following drugs or agents:

Conditions that may mimic anaphylaxis include the following:


Diseases Clinical manifestations Para-clinical findings Gold standard Additional findings
Symptoms Physical examination
Lab Findings Imaging Histopathology
Abdominal pain Diarrhea Flushing Dyspnea Palpitations Other symptoms Wheezing Telangiectasia Hypotension Tachycardia Systolic murmur of tricuspid regurgitation Other physical findings Urinary 5-hydroxyindoleacetic acid (5-HIAA) Serum Chromogranin A (CgA) Other markers Abdominal computed tomography (CT) Abdominal MRI Somatostatin receptor scintigraphy [SRS], or Octreoscan Metaiodobenzylguanidine (MIBG) scintigraphy Other diagnostic studies Transthoracic echocardiography
Carcinoid Syndrome[1][2][3][4][5][6][7][8][9] Neuroendocrine tumor of midgut [10][11][12][13] +

Mild

+ + + +

Dermatitis

Diarrhea

Dementia

Metastatic tumors in the liver: Right upper quadrant pain, hepatomegaly, and early satiety

+ +/- +/- + + - + + + +
  • Valve thickening with retraction and reduction in the mobility of the tricuspid valve

Pathognomonic radiological sign of midgut NET.

Neuroendocrine tumor of lung[14][15][16][17] + + + + +
+ +/- +/- + + - + + Sensitive for detection of liver metastases if present + + - Typical low-grade:bland cells containing regular round nuclei with finely dispersed chromatin and inconspicuous small nucleoli.Mitotic figures are scarce and necrosis is absent.

Intermediate-grade atypical: presence of Neuroendocrine morphology and either necrosis or 2 to 10 mitoses per 10 HPF

Irritable Bowel Syndrome[18][19][20][21] +

Perioidic

- - - - - - - - - - - - - - - - Rome IV criteria
  • Recurrent abdominal pain, at least 1day/week in the last 3 months, a/s with 2 or more of the following criteria:

•Related to defecation

•Associated with a change in stool frequency

•Associated with a change in stool form (appearance)

Malignant neoplasms of small intestine[22][23][24] +/- +/- - - +/- - - +/- - * Abdominal mass - + Abdominal CT scan may be diagnostic of small intestine cancer. Findings on CT scan suggestive of small intestine cancer include intrinsic mass with a short segment of bowel wall thickening MRI and MRI enteroscopy are other advance modalities to diagnose and stage small intestinal cancers - - Enteroscopy, capsule endoscopy and double balloon enteroscopy Biopsy and histopathology
Crohn disease[25][26][27][28] +/- - - - - - - - - - - - - -
  • Focal ulcerations and acute and chronic inflammation
Benign cutaneous flushing[29] - - + - - - - - - - - - - - - - - - - - - -
Systemic mastocytosis[30][31][32][33][34] + + + + - +/- +/- + - - - - - -
Asthma exacerbation[35] -[36][37] - - + + + - - + - - - Chest X ray
Anaphylaxis[38][39][40][41][42] + -/+ + + + +/- - + + - - - - - - - - History of exposure to insect stings,food alllergy,rubber latex,food additives,,allergy to medications,physical factors such s excercise and cold
Histaminergic Angioedema[43][44][45][46][47] +/- +/- + + + + - + + - - - - - - - - - -
  • Take proper clinical history of previous similar episodes
  • Medication history
  • Any allergy to insects stings , foods or any ingestion within previous 24 hours
Medullary Thyroid Carcinoma[48][49][50][51] - +/- +/- +/- - - - - - - - - - - -

For metastasis

-


References

  1. ↑ Rubin de Celis Ferrari AC, Glasberg J, Riechelmann RP (August 2018). "Carcinoid syndrome: update on the pathophysiology and treatment". Clinics (Sao Paulo). 73 (suppl 1): e490s. doi:10.6061/clinics/2018/e490s. PMC 6096975. PMID 30133565.
  2. ↑ Hegyi J, Schwartz RA, Hegyi V (January 2004). "Pellagra: dermatitis, dementia, and diarrhea". Int. J. Dermatol. 43 (1): 1–5. PMID 14693013.
  3. ↑ Savelli G, Lucignani G, Seregni E, Marchianò A, Serafini G, Aliberti G, Villano C, Maccauro M, Bombardieri E (May 2004). "Feasibility of somatostatin receptor scintigraphy in the detection of occult primary gastro-entero-pancreatic (GEP) neuroendocrine tumours". Nucl Med Commun. 25 (5): 445–9. PMID 15100502.
  4. ↑ Savelli G, Lucignani G, Seregni E, Marchianò A, Serafini G, Aliberti G, Villano C, Maccauro M, Bombardieri E (May 2004). "Feasibility of somatostatin receptor scintigraphy in the detection of occult primary gastro-entero-pancreatic (GEP) neuroendocrine tumours". Nucl Med Commun. 25 (5): 445–9. PMID 15100502.
  5. ↑ Bora, ManashKumar; Vithiavathi, S (2012). "Primary bronchial carcinoid: A rare differential diagnosis of pulmonary koch in young adult patient". Lung India. 29 (1): 59. doi:10.4103/0970-2113.92366. ISSN 0970-2113.
  6. ↑ Yazıcıoğlu A, Yekeler E, Bıcakcıoğlu P, Ozaydın E, Karaoğlanoğlu N (December 2012). "Synchronous bilateral multiple typical pulmonary carcinoid tumors: a unique case with 10 typical carcinoids". Balkan Med J. 29 (4): 450–2. doi:10.5152/balkanmedj.2012.081. PMC 4115868. PMID 25207053.
  7. ↑ Krausz Y, Keidar Z, Kogan I, Even-Sapir E, Bar-Shalom R, Engel A, Rubinstein R, Sachs J, Bocher M, Agranovicz S, Chisin R, Israel O (November 2003). "SPECT/CT hybrid imaging with 111In-pentetreotide in assessment of neuroendocrine tumours". Clin. Endocrinol. (Oxf). 59 (5): 565–73. PMID 14616879.
  8. ↑ van der Lely, Aart J.; Herder, Wouter W. de (2005). "Carcinoid syndrome: diagnosis and medical management". Arquivos Brasileiros de Endocrinologia & Metabologia. 49 (5): 850–860. doi:10.1590/S0004-27302005000500028. ISSN 0004-2730.
  9. ↑ Halperin DM, Shen C, Dasari A, Xu Y, Chu Y, Zhou S, Shih YT, Yao JC (April 2017). "Frequency of carcinoid syndrome at neuroendocrine tumour diagnosis: a population-based study". Lancet Oncol. 18 (4): 525–534. doi:10.1016/S1470-2045(17)30110-9. PMC 6066284. PMID 28238592.
  10. ↑ Sjöblom SM (September 1988). "Clinical presentation and prognosis of gastrointestinal carcinoid tumours". Scand. J. Gastroenterol. 23 (7): 779–87. PMID 3227292.
  11. ↑ Ganeshan D, Bhosale P, Yang T, Kundra V (October 2013). "Imaging features of carcinoid tumors of the gastrointestinal tract". AJR Am J Roentgenol. 201 (4): 773–86. doi:10.2214/AJR.12.9758. PMID 24059366.
  12. ↑ Signs and symptoms of carcinoid syndrome. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/patient/gi-carcinoid-treatment-pdq
  13. ↑ Modlin IM, Kidd M, Latich I, Zikusoka MN, Shapiro MD (May 2005). "Current status of gastrointestinal carcinoids". Gastroenterology. 128 (6): 1717–51. PMID 15887161.
  14. ↑ Gustafsson BI, Kidd M, Chan A, Malfertheiner MV, Modlin IM (July 2008). "Bronchopulmonary neuroendocrine tumors". Cancer. 113 (1): 5–21. doi:10.1002/cncr.23542. PMID 18473355.
  15. ↑ Jeung, Mi-Young; Gasser, Bernard; Gangi, Afshin; Charneau, Dominique; Ducroq, Xavier; Kessler, Romain; Quoix, Elisabeth; Roy, Catherine (2002). "Bronchial Carcinoid Tumors of the Thorax: Spectrum of Radiologic Findings". RadioGraphics. 22 (2): 351–365. doi:10.1148/radiographics.22.2.g02mr01351. ISSN 0271-5333.
  16. ↑ Nessi R, Basso Ricci P, Basso Ricci S, Bosco M, Blanc M, Uslenghi C (April 1991). "Bronchial carcinoid tumors: radiologic observations in 49 cases". J Thorac Imaging. 6 (2): 47–53. PMID 1649924.
  17. ↑ Melmon KL, Sjoerdsma A, Mason DT (October 1965). "Distinctive clinical and therapeutic aspects of the syndrome associated with bronchial carcinoid tumors". Am. J. Med. 39 (4): 568–81. PMID 5831899.
  18. ↑ Ford AC, Forman D, Bailey AG, Axon AT, Moayyedi P (May 2008). "Irritable bowel syndrome: a 10-yr natural history of symptoms and factors that influence consultation behavior". Am. J. Gastroenterol. 103 (5): 1229–39, quiz 1240. doi:10.1111/j.1572-0241.2007.01740.x. PMID 18371141.
  19. ↑ Simren M, Palsson OS, Whitehead WE (April 2017). "Update on Rome IV Criteria for Colorectal Disorders: Implications for Clinical Practice". Curr Gastroenterol Rep. 19 (4): 15. doi:10.1007/s11894-017-0554-0. PMC 5378729. PMID 28374308.
  20. ↑ "American Gastroenterological Association medical position statement: irritable bowel syndrome". Gastroenterology. 123 (6): 2105–7. December 2002. doi:10.1053/gast.2002.37095b. PMID 12454865.
  21. ↑ Mearin F, Lacy BE, Chang L, Chey WD, Lembo AJ, Simren M, Spiller R (February 2016). "Bowel Disorders". Gastroenterology. doi:10.1053/j.gastro.2016.02.031. PMID 27144627.
  22. ↑ McLaughlin PD, Maher MM (July 2013). "Primary malignant diseases of the small intestine". AJR Am J Roentgenol. 201 (1): W9–14. doi:10.2214/AJR.12.8492. PMID 23789703.
  23. ↑ Hatzaras I, Palesty JA, Abir F, Sullivan P, Kozol RA, Dudrick SJ, Longo WE (March 2007). "Small-bowel tumors: epidemiologic and clinical characteristics of 1260 cases from the connecticut tumor registry". Arch Surg. 142 (3): 229–35. doi:10.1001/archsurg.142.3.229. PMID 17372046.
  24. ↑ Lepage C, Bouvier AM, Manfredi S, Dancourt V, Faivre J (December 2006). "Incidence and management of primary malignant small bowel cancers: a well-defined French population study". Am. J. Gastroenterol. 101 (12): 2826–32. doi:10.1111/j.1572-0241.2006.00854.x. PMID 17026561.
  25. ↑ Hara AK, Swartz PG (2009). "CT enterography of Crohn's disease". Abdom Imaging. 34 (3): 289–95. doi:10.1007/s00261-008-9443-1. PMID 18649092.
  26. ↑ Baumgart, Daniel C; Sandborn, William J (2012). "Crohn's disease". The Lancet. 380 (9853): 1590–1605. doi:10.1016/S0140-6736(12)60026-9. ISSN 0140-6736.
  27. ↑ Feuerstein, Joseph D.; Cheifetz, Adam S. (2017). "Crohn Disease: Epidemiology, Diagnosis, and Management". Mayo Clinic Proceedings. 92 (7): 1088–1103. doi:10.1016/j.mayocp.2017.04.010. ISSN 0025-6196.
  28. ↑ García-Bosch, O.; Ordás, I.; Aceituno, M.; Rodríguez, S.; Ramírez, A. M.; Gallego, M.; Ricart, E.; Rimola, J.; Panes, J. (2016). "Comparison of Diagnostic Accuracy and Impact of Magnetic Resonance Imaging and Colonoscopy for the Management of Crohn's Disease". Journal of Crohn's and Colitis. 10 (6): 663–669. doi:10.1093/ecco-jcc/jjw015. ISSN 1873-9946.
  29. ↑ Izikson, Leonid; English, Joseph C.; Zirwas, Matthew J. (2006). "The flushing patient: Differential diagnosis, workup, and treatment". Journal of the American Academy of Dermatology. 55 (2): 193–208. doi:10.1016/j.jaad.2005.07.057. ISSN 0190-9622.
  30. ↑ Hartmann, Karin; Escribano, Luis; Grattan, Clive; Brockow, Knut; Carter, Melody C.; Alvarez-Twose, Ivan; Matito, Almudena; Broesby-Olsen, Sigurd; Siebenhaar, Frank; Lange, Magdalena; Niedoszytko, Marek; Castells, Mariana; Oude Elberink, Joanna N.G.; Bonadonna, Patrizia; Zanotti, Roberta; Hornick, Jason L.; Torrelo, Antonio; Grabbe, Jürgen; Rabenhorst, Anja; Nedoszytko, Boguslaw; Butterfield, Joseph H.; Gotlib, Jason; Reiter, Andreas; Radia, Deepti; Hermine, Olivier; Sotlar, Karl; George, Tracy I.; Kristensen, Thomas K.; Kluin-Nelemans, Hanneke C.; Yavuz, Selim; Hägglund, Hans; Sperr, Wolfgang R.; Schwartz, Lawrence B.; Triggiani, Massimo; Maurer, Marcus; Nilsson, Gunnar; Horny, Hans-Peter; Arock, Michel; Orfao, Alberto; Metcalfe, Dean D.; Akin, Cem; Valent, Peter (2016). "Cutaneous manifestations in patients with mastocytosis: Consensus report of the European Competence Network on Mastocytosis; the American Academy of Allergy, Asthma & Immunology; and the European Academy of Allergology and Clinical Immunology". Journal of Allergy and Clinical Immunology. 137 (1): 35–45. doi:10.1016/j.jaci.2015.08.034. ISSN 0091-6749.
  31. ↑ Lee, Jason K; Whittaker, Scott J; Enns, Robert A; Zetler, Peter (2008). "Gastrointestinal manifestations of systemic mastocytosis". World Journal of Gastroenterology. 14 (45): 7005. doi:10.3748/wjg.14.7005. ISSN 1007-9327.
  32. ↑ Horan RF, Austen KF (March 1991). "Systemic mastocytosis: retrospective review of a decade's clinical experience at the Brigham and Women's Hospital". J. Invest. Dermatol. 96 (3): 5S–13S, discussion 13S–14S. PMID 2002264.
  33. ↑ Sokol, Harry; Georgin-Lavialle, Sophie; Grandpeix-Guyodo, Catherine; Canioni, Danielle; Barete, Stéphane; Dubreuil, Patrice; Lortholary, Olivier; Beaugerie, Laurent; Hermine, Olivier (2010). "Gastrointestinal involvement and manifestations in systemic mastocytosis". Inflammatory Bowel Diseases. 16 (7): 1247–1253. doi:10.1002/ibd.21218. ISSN 1078-0998.
  34. ↑ Bedeir A, Jukic DM, Wang L, Mullady DK, Regueiro M, Krasinskas AM (November 2006). "Systemic mastocytosis mimicking inflammatory bowel disease: A case report and discussion of gastrointestinal pathology in systemic mastocytosis". Am. J. Surg. Pathol. 30 (11): 1478–82. doi:10.1097/01.pas.0000213310.51553.d7. PMID 17063092.
  35. ↑ Fuhlbrigge A, Peden D, Apter AJ, Boushey HA, Camargo CA, Gern J, Heymann PW, Martinez FD, Mauger D, Teague WG, Blaisdell C (March 2012). "Asthma outcomes: exacerbations". J. Allergy Clin. Immunol. 129 (3 Suppl): S34–48. doi:10.1016/j.jaci.2011.12.983. PMC 3595577. PMID 22386508.
  36. ↑ Dougherty RH, Fahy JV (February 2009). "Acute exacerbations of asthma: epidemiology, biology and the exacerbation-prone phenotype". Clin. Exp. Allergy. 39 (2): 193–202. doi:10.1111/j.1365-2222.2008.03157.x. PMC 2730743. PMID 19187331.
  37. ↑ Aldington S, Beasley R (May 2007). "Asthma exacerbations. 5: assessment and management of severe asthma in adults in hospital". Thorax. 62 (5): 447–58. doi:10.1136/thx.2005.045203. PMC 2117186. PMID 17468458.
  38. ↑ Peavy RD, Metcalfe DD (August 2008). "Understanding the mechanisms of anaphylaxis". Curr Opin Allergy Clin Immunol. 8 (4): 310–5. doi:10.1097/ACI.0b013e3283036a90. PMC 2683407. PMID 18596587.
  39. ↑ Tupper J, Visser S (October 2010). "Anaphylaxis: A review and update". Can Fam Physician. 56 (10): 1009–11. PMC 2954079. PMID 20944042.
  40. ↑ Kemp SF, Lockey RF (September 2002). "Anaphylaxis: a review of causes and mechanisms". J. Allergy Clin. Immunol. 110 (3): 341–8. PMID 12209078.
  41. ↑ Bjornsson HM, Graffeo CS (December 2010). "Improving diagnostic accuracy of anaphylaxis in the acute care setting". West J Emerg Med. 11 (5): 456–61. PMC 3027438. PMID 21293765.
  42. ↑ "Usefulness and Limitations of Sequential Serum Tryptase for the Diagnosis of Anaphylaxis in 102 Patients - FullText - International Archives of Allergy and Immunology 2013, Vol. 160, No. 2 - Karger Publishers".
  43. ↑ Busse PJ, Smith T (August 2017). "Histaminergic Angioedema". Immunol Allergy Clin North Am. 37 (3): 467–481. doi:10.1016/j.iac.2017.03.001. PMID 28687103.
  44. ↑ Hahn J, Hoffmann TK, Bock B, Nordmann-Kleiner M, Trainotti S, Greve J (July 2017). "Angioedema". Dtsch Arztebl Int. 114 (29–30): 489–496. doi:10.3238/arztebl.2017.0489. PMC 5569554. PMID 28818177.
  45. ↑ Bernstein JA, Cremonesi P, Hoffmann TK, Hollingsworth J (December 2017). "Angioedema in the emergency department: a practical guide to differential diagnosis and management". Int J Emerg Med. 10 (1): 15. doi:10.1186/s12245-017-0141-z. PMC 5389952. PMID 28405953.
  46. ↑ Bernstein JA, Moellman J (November 2012). "Emerging concepts in the diagnosis and treatment of patients with undifferentiated angioedema". Int J Emerg Med. 5 (1): 39. doi:10.1186/1865-1380-5-39. PMC 3518251. PMID 23131076.
  47. ↑ Kaplan AP (June 2008). "Angioedema". World Allergy Organ J. 1 (6): 103–13. doi:10.1097/WOX.0b013e31817aecbe. PMC 3651192. PMID 23282406.
  48. ↑ Pacini F, Castagna MG, Cipri C, Schlumberger M (August 2010). "Medullary thyroid carcinoma". Clin Oncol (R Coll Radiol). 22 (6): 475–85. doi:10.1016/j.clon.2010.05.002. PMID 20627492.
  49. ↑ Roy M, Chen H, Sippel RS (2013). "Current understanding and management of medullary thyroid cancer". Oncologist. 18 (10): 1093–100. doi:10.1634/theoncologist.2013-0053. PMC 3805151. PMID 24037980.
  50. ↑ Mian C, Perrino M, Colombo C, Cavedon E, Pennelli G, Ferrero S, De Leo S, Sarais C, Cacciatore C, Manfredi GI, Verga U, Iacobone M, De Pasquale L, Pelizzo MR, Vicentini L, Persani L, Fugazzola L (May 2014). "Refining calcium test for the diagnosis of medullary thyroid cancer: cutoffs, procedures, and safety". J. Clin. Endocrinol. Metab. 99 (5): 1656–64. doi:10.1210/jc.2013-4088. PMID 24552221.
  51. ↑ Bae YJ, Schaab M, Kratzsch J (2015). "Calcitonin as Biomarker for the Medullary Thyroid Carcinoma". Recent Results Cancer Res. 204: 117–37. doi:10.1007/978-3-319-22542-5_5. PMID 26494386.

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