@article{1a878c89636743a88caea4b48c4fae89,
title = "Differential Diagnosis of Diarrhea in Patients with Neuroendocrine Tumors",
abstract = "Patients with neuroendocrine tumors (NETs) and carcinoid syndrome experience diarrhea that can have a debilitating effect on quality of life. Diarrhea also may develop in response to other hormonal syndromes associated with NETs, surgical complications, medical comorbidities, medications, or food sensitivities. Limited guidance on the practical approach to the differential diagnosis of diarrhea in these patients can lead to delays in appropriate treatment. This clinical review and commentary underscore the complexity in identifying the etiology of diarrhea in patients with NETs. Based on our collective experience and expertise, we offer a practical algorithm to guide medical oncologists and other care providers to expedite effective management of diarrhea and related symptoms in patients with NETs.",
keywords = "carcinoid syndrome, diagnostic algorithm, neuroendocrine tumor, osmolar gap, secretory diarrhea",
author = "Eads, {Jennifer R.} and Diane Reidy-Lagunes and Soares, {Heloisa P.} and Chan, {Jennifer A.} and Anthony, {Lowell B.} and Halfdanarson, {Thorvardur R.} and Naraev, {Boris G.} and Wolin, {Edward M.} and Halperin, {Daniel M.} and Daneng Li and Pommier, {Rodney F.} and Zacks, {Jerome S.} and Morse, {Michael A.} and Metz, {David C.}",
note = "Funding Information: From the *Department of Medicine, Division of Hematology and Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; †Department of Medicine, Division of Solid Tumor, Gastrointestinal Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY; ‡Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; §Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; ||Division of Medical Oncology, University of Kentucky Medical Center, Markey Cancer Center, Lexington, KY; ¶Division of Medical Oncology, Mayo Clinic Cancer Center, Rochester, MN; #Division of Cancer Medicine, Banner MD Anderson Cancer Center, The University of Texas MD Anderson Cancer Center, Gilbert, AZ; **Department of Medicine, Division of Hematology/Oncology, Icahn School of Medicine, Center for Carcinoid and Neuroendocrine Tumors, Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY; ††Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; ‡‡Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, CA; §§Division of Surgical Oncology, Oregon Health & Science University, Portland, OR; ||||Department of Medicine (Cardiology), The Mount Sinai School of Medicine, The Carcinoid Heart Center, New York, NY; ¶¶Department of Medical Oncology, Duke University Medical Center, Durham, NC; ##Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Received for publication February 3, 2020; accepted July 22, 2020. Address correspondence to: David C. Metz, MD, Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, 7 PCAM S, 1 Convention Ave, Philadelphia, PA 19104 (e‐mail: david.metz@pennmedicine.upenn.edu). This study was supported by Lexicon Pharmaceuticals, Inc. L.B.A. reports consulting for Lexicon Pharmaceuticals, Inc. and has received grants from Lexicon Pharmaceuticals, Inc. J.A.C. reports consulting for Crinetics, Ipsen, Novartis, and Lexicon (spouse has consulted for Bayer and Pfizer); royalties from UpToDate; and stock from Merck. J.R.E. reports consulting for Lexicon (ongoing) and Novartis (within past 2 years); advisory board/speaking engagements for Exelixis, Pfizer, Novartis, and Advanced Accelerator Applications; employment in Bristol Meyers Squibb (spouse); stocks from Bristol Meyers Squibb (pending); and honoraria from Pfizer (talk). T.R.H. reports consulting for Ipsen, Advanced Accelerator Applications, Lexicon, Curium, and TERUMO and research support from Thermo Fisher Scientific and Ipsen. D.M.H. reports consulting for Ipsen, Advanced Accelerator Applications, Lexicon, Novartis, AbbVie, and Curium and research support from Genentech/Roche, Tarveda Therapeutics, Thermo Fisher Scientific, Incyte, Lexicon, and Advanced Accelerator Applications. D.L. reports consulting for Lexicon Pharmaceuticals, Advanced Accelerator Applications, Bayer, Genentech USA, Taiho Oncology, Eisai, Exelixis, and Ipsen. D.C.M. reports consulting for Ipsen, Advanced Accelerator Applications, Lexicon, Wren Laboratories, and Intercept. M.A.M. reports consulting for Celgene, Sun Pharmaceuticals, Genentech/Roche, Lexicon (other—speaker's bureau), Novartis, Taiho Pharmaceutical (other—speaker's bureau), Bayer, Ipsen, Novartis, Regeneron, Sanofi, Advanced Accelerator Applications, AlphaVax, Bristol-Myers Squibb, Eisai (other—speaker's bureau), MedImmune, Merck, AstraZeneca AB, and Exelixis (other—speaker's bureau). B.G.N. reports consulting for Advanced Accelerator Applications, Lexicon, Novocure, and Sun Pharmaceutical Industries, Inc. R.F.P. reports consulting for Ipsen, Advanced Accelerator Applications, Lexicon Pharmaceuticals, and Novartis and participation in speaker's bureau for Novartis. D.R.-L. reports consulting for Advanced Accelerator Applications, Lexicon, and Bind Insurance and research support from Merck, Ipsen, and Novartis. H.P.S. reports consulting for Lexicon Pharmaceuticals, Ipsen, Advanced Accelerator Applications, QED Therapeutics, and Exelixis. E.M.W. reports a consulting or advisory role for Novartis, Advanced Accelerator Applications, Lexicon, Ipsen, and Progenics. J.S.Z. reports consulting for Lexicon Pharmaceuticals. Publisher Copyright: {\textcopyright} Wolters Kluwer Health, Inc. All rights reserved.",
year = "2020",
month = oct,
doi = "10.1097/MPA.0000000000001658",
language = "English (US)",
volume = "49",
pages = "1123--1130",
journal = "Pancreas",
issn = "0885-3177",
publisher = "Lippincott Williams and Wilkins",
number = "9",
}