Reversal of a neurologic paraneoplastic syndrome with octreotide (Sandostatin) in a patient with glucagonoma.
A 69-year-old woman with classic glucagonoma syndrome had associated progressive neurologic disease manifest as dementia, ataxia, optic atrophy, and lower limb weakness. Visual evoked responses (VERs) were absent bilaterally. After an attempt at resection was unsuccessful, therapy was started with somatostatin analogue (Sandostatin, SMS 201-995). Over the ensuing 3 months, there was a decrease in the plasma glucagon level, resolution of the rash, weight gain, reversal of the dementia, and an improvement in coordination and limb weakness. Subsequent VERs revealed bilateral delayed responses.
Holmes
A
A
Department of Medical Oncology, Royal Melbourne Hospital, Victoria, Australia.
Kilpatrick
C
C
Proietto
J
J
Green
M D
MD
D000368:Aged; D005074:Evoked Potentials, Visual / Q000187:drug effects; D005260:Female; D005934:Glucagon / Q000097:blood; D005935:Glucagonoma / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D015282:Octreotide / Q000494:pharmacology / Q000627:therapeutic use*; D009896:Optic Atrophy / Q000175:diagnosis / Q000209:etiology*; D010190:Pancreatic Neoplasms / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D010257:Paraneoplastic Syndromes / Q000209:etiology* / Q000503:physiopathology; D014792:Visual Acuity / Q000187:drug effects
D005934:Glucagon; D015282:Octreotide