Hospital Putrajaya, Department of Medicine, Endocrine Unit, Wilayah Persekutuan Putrajaya, Malaysia.
Hospital Kuala Lumpur, Department of Medicine, Endocrine Unit, Wilayah Persekutuan Kuala Lumpur, Malaysia.
Med J Malaysia. 2022 Jan;77(1):128-131.
Peptide receptor radionuclide therapy (PRRT) is a therapeutic option in inoperable or metastatic neuroendocrine tumours (NETs). PRRT proved to be promising in prolonging survival and delaying disease progression in patients with advanced bronchopulmonary carcinoid. However, it may lead to worsening of carcinoid symptoms or even precipitate carcinoid crises. The incidence of PRRT induced carcinoid crisis would be between 1-10%. This usually takes place during the first PRRT cycle, either during the tracer infusion or 12-48 hours' post-administration. We report a 62-year-old man with underlying metastatic lung carcinoid tumour who developed carcinoid crisis at 10 hours after receiving PRRT. The carcinoid crisis was successfully treated with intravenous octreotide infusion, corticosteroid, a selective 5-HT3 receptor antagonist, parenteral ranitidine and chlorpheniramine for H1 and H2 antagonism respectively.
肽受体放射性核素治疗 (PRRT) 是不可手术或转移性神经内分泌肿瘤 (NET) 的一种治疗选择。PRRT 已被证明在延长晚期肺支气管类癌患者的生存时间和延缓疾病进展方面具有潜力。然而，它可能导致类癌症状恶化，甚至引发类癌危象。PRRT 诱导的类癌危象的发生率在 1-10%之间。这通常发生在第一个 PRRT 周期期间，无论是在示踪剂输注期间还是在给药后 12-48 小时。我们报告了一名 62 岁男性，患有潜在的转移性肺类癌肿瘤，在接受 PRRT 后 10 小时发生类癌危象。类癌危象通过静脉注射奥曲肽、皮质类固醇、选择性 5-HT3 受体拮抗剂、肌内雷尼替丁和氯苯那敏（分别用于 H1 和 H2 拮抗）成功治疗。
