Octreotide
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Reactions 1432 - 15 Dec 2012 ★ Octreotide First report of night blindness: case report A 62-year-old woman developed night blindness during treatment with octreotide. The woman was on chronic haemodialysis for end-stage renal disease (ESRD) due to autosomal dominant polycystic kidney disease (ADPKD). She developed a massive polycystic liver, and she was given a single test dose of short-acting SC octreotide 100µg. Several hours after administration, she developed abdominal cramps, diarrhoea and vomiting. Those symptoms disappeared the next day, and she was started on monthly long-acting octreotide 20mg injections. A few hours after her injection, she developed nausea, vomiting and diarrhoea. The nausea and vomiting resolved, but the diarrhoea persisted. Therefore, her monthly octreotide dose was decreased to 10mg. After 3 months of treatment, she had persistent diarrhoea. She also had fatty and discoloured stools. At this time, she also reported a loss of nocturnal peripheral vision. She had vitamin A and β-carotene serum levels of 277 µg/L and 7 µg/L, respectively. Octreotide was withdrawn, and the woman’s diarrhoea resolved in the ensuing months. Her visual defect also recovered, and her vitamin A levels normalised. At last follow-up, she was waiting for a combined kidney and liver transplantation. Author comment: "Vitamin A and β-carotene serum levels were markedly lowered in our patient . . . This severe deficiency was very likely to result from vitamin A malabsorption in relation to chronic steatorrhea, a known side effect of somatostatin analogs." Ho TA, et al. Night blindness in a haemodialysed ADPKD patient receiving octreotide. Clinical Kidney Journal 5: 474-475, No. 5, Oct 2012. Available from: URL: http://dx.doi.org/10.1093/ckj/sfs121 - Belgium 803081136 » Editorial comment: A search of AdisBase, Medline and Embase did not reveal any previous case reports of night blindness associated with octreotide. The WHO ADR database contained three reports of night blindness associated with octreotide. 1 Reactions 15 Dec 2012 No. 1432 0114-9954/10/1432-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Octreotide
Reactions 1432 - 15 Dec 2012
★Octreotide
First report of night blindness: case reportA 62-year-old woman developed night blindness during
treatment with octreotide.The woman was on chronic haemodialysis for end-stage
renal disease (ESRD) due to autosomal dominant polycystickidney disease (ADPKD). She developed a massivepolycystic liver, and she was given a single test dose ofshort-acting SC octreotide 100µg. Several hours afteradministration, she developed abdominal cramps,diarrhoea and vomiting. Those symptoms disappeared thenext day, and she was started on monthly long-actingoctreotide 20mg injections. A few hours after her injection,she developed nausea, vomiting and diarrhoea. The nauseaand vomiting resolved, but the diarrhoea persisted.Therefore, her monthly octreotide dose was decreased to10mg. After 3 months of treatment, she had persistentdiarrhoea. She also had fatty and discoloured stools. At thistime, she also reported a loss of nocturnal peripheralvision. She had vitamin A and β-carotene serum levels of277 µg/L and 7 µg/L, respectively.
Octreotide was withdrawn, and the woman’s diarrhoearesolved in the ensuing months. Her visual defect alsorecovered, and her vitamin A levels normalised. At lastfollow-up, she was waiting for a combined kidney and livertransplantation.
Author comment: "Vitamin A and β-carotene serum levelswere markedly lowered in our patient . . . This severedeficiency was very likely to result from vitamin Amalabsorption in relation to chronic steatorrhea, a knownside effect of somatostatin analogs."Ho TA, et al. Night blindness in a haemodialysed ADPKD patient receivingoctreotide. Clinical Kidney Journal 5: 474-475, No. 5, Oct 2012. Available from:URL: http://dx.doi.org/10.1093/ckj/sfs121 - Belgium 803081136
» Editorial comment: A search of AdisBase, Medline andEmbase did not reveal any previous case reports of nightblindness associated with octreotide. The WHO ADRdatabase contained three reports of night blindnessassociated with octreotide.
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Reactions 15 Dec 2012 No. 14320114-9954/10/1432-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
