Octreotide improved ventricular arrhythmia in an acromegalic patient.
We saw a remarkable effect of octreotide, the long-acting somatostatin analogue, in reducing the number of ventricular premature complexes (VPCs) in a 59-year-old woman with acromegaly. Her basal GH and IGF-1 levels were up to 22.9 ng/ml and 934.9 ng/ml respectively. MRI revealed a 14 x 12 x 10 mm mass lesion in the pituitary gland. She had hypertension and echocardiography showed an increase in left ventricular wall thickness. Electric cardiography showed the presence of frequent VPCs and 24-h Holter monitoring revealed 24,277 beats of multifocal VPCs/24 h. She was treated with 300 microg/day of octreotide for four weeks before transsphenoidal surgery. After octreotide treatment, GH and IGF-1 were suppressed to 1.8 ng/ml and 145.3 ng/ml respectively, and the tumor size was remarkably reduced. Furthermore, the number of VPCs was also dramatically reduced to 2062 VPCs/24-h (8.5% of pretreatment) with 24-h Holter monitoring. This case shows that VPCs of acromegalic patients can be controlled by suppressing GH and IGF-1 with octreotide, and this agent is useful for reducing both tumor size and frequency of VPCs prior to surgery.
Suyama
K
K
Second Department of Internal Medicine, Chiba University School of Medicine, Japan.
Uchida
D
D
Tanaka
T
T
Saito
J
J
Noguchi
Y
Y
Nakamura
S
S
Tatsuno
I
I
Saito
Y
Y
Saeki
N
N
D000172:Acromegaly / Q000097:blood / Q000150:complications* / Q000209:etiology; D000236:Adenoma / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D005117:Cardiac Complexes, Premature / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006728:Hormones / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery
D006728:Hormones; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D015282:Octreotide