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The art of medicine

BMJ 2016; 354 doi: (Published 08 July 2016) Cite this as: BMJ 2016;354:i2149
  1. Mark Edmondstone, retired consultant physician
  1. Winchester
  1. markedmondstone{at}

Without doubt he had carcinoid syndrome. The patient had levels of 5-hydroxyindoleacetic acid (5-HIAA) way above those required to confirm the diagnosis. The history was textbook-typical. All that remained was to answer his many questions and formulate a management plan. I realised my knowledge of carcinoid syndrome had not been refreshed since MRCP days, and, …

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