Reactions 1515, p138 - 23 Aug 2014

SOctreotide

Thrombocytopenia: 3 case reportsThree patients two men and a woman aged 43,52 and

54 years old respectively developed thrombocytopeniafollowing administration of octreotide for uppergastrointestinal bleeding.

A 43-year-old man who had a history of hepatitis B, cirrhosisand gastric fundus and oesophageal varices presented withblack stools for 2 days. Initial examination revealed bloodpressure 95/69 mmHg, heart rate 110 beats/min, and arterialoxygen saturation 99% along with palmar erythema, ascites,and an active bowel sound. The man was hospitalised andadministered normal saline and glucose solution. He wasstarted on intravenous octreotide at a loading dose 50 µg andthen continued by pump at a dose of 50 µg/h along withpantoprazole. A follow up test done after 24 hours revealed adecrease in platelet count which continued decreasing duringthe treatment. On day 4 octreotide was stopped. Blood testsdone after 24 hours revealed gradual increment in plateletcount which returned to initial level by day 5.

A 52-year-old man who had a history of hepatitis C, gastricfundus and oesophageal varices and bleeding presented withhaematemesis for 8 hours. The man was treated with bloodvolume expansion and was started on intravenous octreotideat a loading dose 50 µg and then continued via pump at a doseof 50 µg/h along with pantoprazole. Blood tests done after9 and 24 hours respectively showed a decrease in plateletcount which continued decreasing during the treatment. Onday 2 octreotide was stopped. Blood tests done after 24 hoursrevealed gradual increment in platelet count which returned toinitial level by day 8.

A 54-year-old woman who had a history of autoimmunecirrhosis with gastric fundus and oesophageal varicespresented with black stools for 1 day. The woman was startedon intravenous octreotide at a loading dose 50 µg and thencontinued via pump at a dose of 50 µg/h along withpantoprazole. Blood tests done after 8 and 24 hoursrespectively showed a decrease in platelet count whichcontinued decreasing during the treatment. On day 5octreotide was stopped. Blood tests done after 24 hoursrevealed gradual increment in platelet count which returned toinitial level by day 8.

Author comment: For the three cases with octreotide-induced thrombocytopenia in our report, their clinicalcharacteristics are consistent with the above description.Yang J, et al. Three case reports and literature review of octreotide-inducedthrombocytopenia. Chinese Journal of New Drugs 23: 1344-1346, No. 11, 15 Jun2014 [Chinese; summarised from a translation] - China 803107079

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