Restoration of gallbladder contractility after withdrawal of long-term octreotide therapy in acromegalic patients.
We sought to examine how the discontinuation of octreotide in long-term octreotide-treated acromegalic patients affects the well-documented side-effect of cholelithiasis. In 14 acromegalic patients, serum growth hormone levels, insulin-like growth factor I levels and percentage of relative gallbladder contractility were measured prior to and after the discontinuation of octreotide. Compared to pretreatment values, the basal growth hormone and 5-h growth hormone profiles were 36% and 24%, and 60% and 56% at the end of 1 and 2 weeks, respectively. Octreotide was found to be eliminated completely from the serum within 3 days after its withdrawal. In all of six patients who did not develop gallstones, the percentage relative gallbladder contractility normalized within 1 week. In eight patients who developed gallstones, four of them had restoration of normal contractility within 2 weeks. Our results show that upon withdrawal of octreotide, gallbladder contractility returns to normal while growth hormone suppression persists for a longer period of time. Therefore, discontinuation of octreotide therapy may allow for the clearance of stagnated bile and hence decrease the incidence of cholelithiasis in acromegalic patients receiving long-term therapy.
Shi
Y F
YF
Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China.
Zhu
X F
XF
Harris
A G
AG
Zhang
J X
JX
Deng
J Y
JY
D000172:Acromegaly / Q000188:drug therapy* / Q000503:physiopathology; D000328:Adult; D002769:Cholelithiasis / Q000139:chemically induced* / Q000503:physiopathology; D005260:Female; D005704:Gallbladder / Q000503:physiopathology*; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D015282:Octreotide / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood
D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D015282:Octreotide