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Cheung and Earl¹ describe a family consisting of a mother and 2 sons exhibiting similar clinical and biochemical manifestations, which these authors suggest constitute a syndrome due to an inherited monoamine oxidase (MAO) deficiency. Elevated blood serotonin and normal or low-normal urinary 5-hydroxyindoleacetic acid (5-HIAA) levels are noted in all 3 subjects who manifest symptoms reminiscent of carcinoid syndrome, presumably largely due to their excess of circulating serotonin. These clinical features are long-term recurrent episodic facial flushing, headache, diarrhea, and psychiatric symptoms. The sons in particular are described as exhibiting symptoms strongly suggestive of attention-deficit/hyperactivity disorder.

Biochemical and imaging studies for carcinoid tumor, pheochromocytoma, and other humoral causes of the symptoms are negative. A slight increase in 24-hour urinary normetanephrine level is seen in the 2 sons. However, that is not inconsistent with reduced MAO activity.

The authors treated the mother and 1 son with sertraline hydrochloride on the rationale . . . [Full Text of this Article]

RELATED ARTICLE

Monoamine Oxidase Deficiency: A Cause of Flushing and Attention-Deficit/ Hyperactivity Disorder?
N. Wah Cheung and John Earl
Arch Intern Med. 2001;161(20):2503-2504.
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