Suppression of ectopic adrenocorticotropin secretion by the long-acting somatostatin analog octreotide.

Abstract

The long-acting somatostatin analog (octreotide) was administered to a 37-yr-old woman with the ectopic ACTH syndrome. The patient had diffuse metastatic spread of a nonpituitary tumor, presumably of pancreatic origin, and severe and rapidly progressive hypercortisolism with extreme myopathy, hypokalemia, and diabetes mellitus. Plasma ACTH and lipotropin levels and 24-h urinary cortisol excretion were greatly elevated [218 pg/mL (48 pmol/L), 1340 pg/mL (220 pmol/L), and up to 830 micrograms/24 h (2290 nmol/day), respectively]. Urinary cortisol excretion decreased to normal within 3 days after the initiation of octreotide therapy (150, 300, and 600 micrograms/day), and plasma ACTH and lipotropin levels also decreased. Urinary cortisol excretion remained normal for 2 months during chronic octreotide therapy, and her general condition improved dramatically. The only side-effect was a slight increase in the number of bowel movements. Tumor progression, however, was not controlled, and she eventually died of hepatic insufficiency. These data indicate that octreotide can be a highly effective treatment for patients with the ectopic ACTH syndrome.

• Authors: X Bertagna, C Favrod-Coune, H Escourolle, P Beuzeboc, B Christoforov, F Girard, J P Luton
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 68 Issue 5 Pg. 988-91 (May 1989) ISSN: 0021-972X [Print] United States
• PMID: 2565915 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Gastrins
• Somatostatin
• Adrenocorticotropic Hormone
• beta-Lipotropin
• Octreotide
• Hydrocortisone

Topics

• ACTH Syndrome, Ectopic (drug therapy, metabolism)
• Adrenocorticotropic Hormone (blood)
• Adult
• Female
• Gastrins (blood)
• Humans
• Hydrocortisone (metabolism)
• Neoplasms, Unknown Primary (drug therapy, metabolism)
• Octreotide (therapeutic use)
• Pancreatic Neoplasms (drug therapy, metabolism)
• Paraneoplastic Endocrine Syndromes (drug therapy)
• Saliva (metabolism)
• Somatostatin (analogs & derivatives)
• beta-Lipotropin (blood)