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Síndrome carcinoide que imita el síndrome del intestino irritable: no caigas en la trampa
Sara Massironi1, Camilla Gallo2, Marianna Franchina3
1Vita e Salute San Raffaele University, Milan, Italy.
Expert review of gastroenterology & hepatology
|September 3, 2025
Resumen
El síndrome carcinoide (CS) a menudo imita el síndrome del intestino irritable (IBS) debido a síntomas similares. El reconocimiento temprano de señales de alarma específicas y el diagnóstico dirigido son cruciales para el diagnóstico preciso y el tratamiento oportuno de la esclerosis múltiple.
Área de la Ciencia:
- Gastroenterología
- En el campo de la oncología
- Endocrinología
Sus antecedentes:
- El síndrome carcinoide (CS) surge de las neoplasias neuroendocrinas (NEN), que liberan sustancias activas.
- Los síntomas gastrointestinales de la esclerosis múltiple se superponen con frecuencia con el síndrome del intestino irritable (SII), lo que provoca un diagnóstico erróneo.
- La sobreproducción de serotonina es un mecanismo fisiopatológico clave en la EC.
Objetivo del estudio:
- Para explorar la fisiopatología CS, centrándose en la serotonina.
- Para resaltar la superposición clínica y los desafíos de diagnóstico entre CS y IBS.
- Identificar las características diferenciadoras y las herramientas de diagnóstico para el CS.
Principales métodos:
- Una búsqueda exhaustiva de la literatura (PubMed, Embase y la Biblioteca Cochrane).
- Centrarse en los estudios publicados entre enero de 2000 y marzo de 2024.
- Revisión de los mecanismos fisiopatológicos, la presentación clínica y las modalidades de diagnóstico.
Principales resultados:
- Los síntomas de CS como enrojecimiento, diarrea y dolor abdominal a menudo se diagnostican erróneamente como SII.
- Distinguir el lavado "seco" (CS) del lavado "húmedo" (IBS / ansiedad) es un diferenciador clave.
- La falta de respuesta a las terapias IBS y los desencadenantes de alimentos / alcohol sugieren CS.
Conclusiones:
- La identificación temprana de los síntomas de bandera roja es vital para el diagnóstico de CS.
- Las herramientas de diagnóstico dirigidas, incluidos los biomarcadores (5-HIAA) y las imágenes (PET/CT), ayudan a distinguir la EC del SII.
- La reducción del diagnóstico erróneo mejora los resultados de los pacientes y permite una intervención oportuna para el CS.
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