Circulation of a fragment of haemoglobin alpha-chain during a pentagastrin-induced flush in patients with metastatic carcinoid tumours.

Intravenous injection of pentagastrin (0.6 microgram/kg body wt) into two patients with metastatic carcinoid tumours evoked a severe carcinoid flush. Analysis by reverse-phase HPLC of acetone-extracts of peripheral blood taken from the patients during the flush indicated the presence of a peptide identified as the residues (1-33) fragment of the alpha-chain of haemoglobin. The peptide was not detected in blood taken from the patients immediately before stimulation of the flush or in the blood of healthy subjects after pentagastrin injection. The observation is interpreted as evidence that the pentagastrin-induce carcinoid flush is associated with the activation and possible release of a tumour protease that result in damage to erythrocytes.