Diagnostics
Flush syndrome can have a variety of possible causes, so that a general diagnosis cannot be made. The most important measure at the beginning of the diagnosis is a detailed anamnesis (interview) of the affected patient. Of particular interest here are questions about the occurrence, frequency and duration of flush syndrome and possible accompanying symptoms, such as diarrhea, weight loss or stress.
In this context, a survey on the use of medication is also particularly important. High blood pressure (see hypertension) as a possible cause can be ruled out by measuring the blood pressure several times and by arranging for a 24-hour blood pressure measurement. If one has a suspicion as to what may cause flush syndrome, some more complex diagnostic methods such as imaging procedures or laboratory tests can be carried out in the next step.
If there is a suspicion of a mass, i.e. a tumor, an ultrasound examination of the abdomen or an x-ray of the chest can be arranged. In addition, some values can be determined in the blood or urine, which can allow conclusions to be drawn about the cause of flush syndrome. These include the breakdown product of the hormone serotonin (5-hydroxyindolyl acetic acid) and chromogranin-A, which is a tumor marker for pheochromocytoma. This is a tumor of the adrenal cortex, which is typically associated with flush syndrome and can cause high blood pressure.
Therapy
The treatment of flush syndrome depends on the particular trigger of the symptoms. If flush syndrome occurs as a side effect of taking medication, the triggering medication can be discontinued or switched to another preparation. When taking Tecfidera®, the flush symptoms should decrease over time and eventually disappear completely.
If a flush syndrome occurs during the intake of food or when drinking alcohol, it is also important to avoid the corresponding foods. In flush syndrome in the context of an allergy, there are numerous drugs that are used in therapy. These include above all so-called antihistamines and cortisone preparations. If the flush syndrome occurs due to a tumor disease, it is essential to treat the underlying disease. Depending on the stage and extent of the tumor, surgical therapy, chemotherapeutic treatment or radiotherapy is used.