Flushing in (neuro)endocrinology
Open accessAbstract
Cutaneous flushing is a common presenting complaint in endocrine disorders. The pathophysiology of flushing involves changes in cutaneous blood flow triggered by multiple intrinsic factors that are either related to physiology or disease. Flushing can be divided into episodic or persistent causes. Episodic flushing is mediated by the release of endogenous vasoactive mediators or medications, while persistent flushing results in a fixed facial erythema with telangiectasia and cyanosis due to slow-flowing deoxygenated blood in large cutaneous blood vessels. The differential diagnosis of cutaneous flushing in neuroendocrine disorders is limited, yet encompasses a broad spectrum of benign and malignant entities, including carcinoid syndrome, pheochromocytoma, Cushing syndrome, medullary thyroid cancer, and pancreatic neuroendocrine tumors. In this review, we provide a concise and up-to-date discussion on the differential diagnosis and approach of flushing in neuroendocrinology.
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Most symptoms attributable to mast cell activation, such as isolated flushing, pruritus, headache, abdominal pain, or tachycardia, are not specific to mast cells but can be found in other clinical conditions and disorders.
“This is because most symptoms attributable to MCA, such as isolated fl ushing, pruritus, headache, abdominal pain, or tachycardia, are not speci fi c to MCs but can be found in other clinical conditions and disorders as well. 112-118”
From Selecting the Right Criteria and Proper Classification to Diagnose Mast Cell Activation Syndromes: A Critical Review (2021) · cites this paper as [117]
The Introduction lists mastocytosis among many possible causes of flushing, and Initial evaluation says that most conditions presenting with flushing overlap in symptoms. This supports the claim that flushing and associated symptoms are not specific to mast cells. The paper does not establish the full listed set—particularly headache and tachycardia—as symptoms attributable to mast cell activation that also occur in other conditions (page numbers unavailable). (LLM, conf=0.82)
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References 66 · Cited by 67
- Authors
- Hannah-Shmouni, F., Stratakis, C. A., & Koch, C. A.
- Affiliations
- National Institutes of Health (US)
- University of Mississippi Medical Center (US)
- Corresponding author
- Koch, Christian A.
- Venue
- Reviews in Endocrine and Metabolic Disorders
- Published
- 2016-09
- Volume
- 17
- Issue
- 3
- Pages
- 373-380
- ISSN
- 1389-9155 (ISSN-L)
- 1573-2606
- PMC
- PMC5161029
- OpenAlex
- W2555067145
- Cited by
- 67
- References
- 66
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 8 · 2023: 7 · 2022: 9 · 2021: 2 · 2020: 10 · 2019: 4 · 2018: 8 · 2017: 9 · 2016: 2
- FWCI
- 1.04
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Reviews in Endocrine and Metabolic Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (Z99HD999999)
- Topics
- Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
- Health Sciences › Medicine › Physiology › Sympathectomy and Hyperhidrosis Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Keywords
- cutaneous flushing, neuroendocrine disorders, skin blood flow, vasoactive mediators, carcinoid syndrome, pheochromocytoma, Cushing's syndrome, medullary thyroid carcinoma, pancreatic neuroendocrine tumors, differential diagnosis, facial erythema, telangiectasia
- MeSH terms
- Endocrine System Diseases, Flushing, Humans, Neuroendocrine Tumors
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