Can somatostatin control acute bleeding from oesophageal varices in Schistosoma mansoni patients?[ISRCTN63456799].
BACKGROUND
Management of patients with bleeding oesophageal varices comprises of mainly diagnostic endoscopy, sclerotherapy and band ligation. One of the major problems to do any of the above is the active bleeding which makes any intervention difficult. The neuropeptide hormone somatostatin administered exogenously has caused a reduction in portal hypertension and variceal bleeding in patients suffering from liver cirrhosis. We believe that the symptomatic use of somatostatin for variceal bleeding in Schistosoma mansoni infected subjects can reduce bleeding, thereby alleviating the pathology caused by schistosomiasis.


METHODS
We herein present a study protocol for establishing this neuropeptide as a potential therapeutic agent in schistosomiasis. Adolescent subjects, age range varying from 12-17 years will be selected, based on several inclusion criteria, most important being infection with Schistosoma mansoni with bleeding from oesophageal varices in the last 24 hours. One group of schistosomiasis patients will be treated with somatostatin and praziquantel, the other with propanolol and praziquantel. Survival graphs will be set up to correlate somatostatin administration with survival time. A two part questionnaire will be set up to control treatment outcomes. The pre-treatment part of the clinical questionnaire will identify inclusion criteria questions, the post-treatment part of the questionnaire will identify treatment outcomes.


CONCLUSIONS
We expect that the administration of somatostatin as a bolus followed by a 24 hour long infusion, will stop bleeding immediately, delay rebleeding as compared to the control study group and delay mortality in the somatostatin treated subjects.
Chatterjee
Shyama
S
Laboratory of Pathology, Faculty of Medicine, University of Antwerp, Universiteitsplein-1, 2610 Antwerp, Belgium. Shyama.Chatterjee@ua.ac.be
Van Marck
Eric
E
D000293:Adolescent; D000871:Anthelmintics / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002648:Child; D004359:Drug Therapy, Combination; D004932:Esophageal and Gastric Varices / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D006728:Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D010865:Pilot Projects; D011223:Praziquantel / Q000627:therapeutic use; D011433:Propranolol / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012555:Schistosomiasis mansoni / Q000150:complications* / Q000188:drug therapy; D013004:Somatostatin / Q000008:administration & dosage / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
D000871:Anthelmintics; D000959:Antihypertensive Agents; D006728:Hormones; D013004:Somatostatin; D011223:Praziquantel; D011433:Propranolol