Berry E M, Maunder C, Wilson M
Gut. 1974 Jan;15(1):34-8. doi: 10.1136/gut.15.1.34.
A case of the carcinoid syndrome associated with a proximal myopathy is reported. Histology showed advanced atrophy of type II muscle fibres but no inflammation. Perinuclear acid phosphatase was increased. Electron microscopy revealed persistence of the Z-line until the muscle fibre had been severely disrupted. Similar lesions have been observed in the hereditary muscular dystrophy in mice, and also in these animals and in rats when injected with 5-hydroxytryptamine (5-HT). Treatment with cyproheptadine caused a documented response in the patient's debilitating diarrhoea and also produced symptomatic improvement in her muscular power. We suggest that the myopathy is due to circulating 5-HT or is a non-metastatic complication of the carcinoid tumour.
报告了一例类癌综合征合并近端肌病的病例。组织学检查显示II型肌纤维严重萎缩，但无炎症。核周酸性磷酸酶增加。电子显微镜检查发现Z线持续存在，直至肌纤维严重破坏。在小鼠遗传性肌肉营养不良中也观察到类似病变，并且在这些动物和大鼠注射5-羟色胺（5-HT）时也观察到类似病变。用赛庚啶治疗使患者衰弱性腹泻有记录的反应，并且其肌肉力量也有症状改善。我们认为肌病是由于循环中的5-HT所致，或是类癌肿瘤的非转移性并发症。
