Immunoreactive Somatostatin in Pancreatic Islet-Cell Carcinoma Accompanied by Ectopic A.C.T.H. Syndrome

Kovacs, K; Horváth, Éva; Ezrin, Calvin; Sepp, Harry; I, Elkan

doi:10.1016/s0140-6736(77)92578-8

Cited by 59 publications

(14 citation statements)

References 5 publications

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“…With this dose, plasma SST concentrations similar to those found in patients with somatostatino mas are observed [12][13][14][15][16], Therefore, the decrease in bile flow and the increase in bile cholesterol saturation reported in the present study may well occur in the two clinical situ ations mentioned above. Thus, in addition to the decrease in exocrine pancreatic secre tion, this decrease in bile flow may also con tribute to SST-induced steatorrhea.…”

Section: Discussionsupporting

confidence: 79%

“…However, to our knowledge, the influence of SST on bile flow and biliary lipid composition in man remains undeter mined. Two clinical features suggest a possi ble cholestatic effect of excessive circulating SST in man; on the one hand, gallstones arc a very frequent feature in patients with somatostatinomas [12][13][14][15][16], and on the other hand, the pathogenesis of SST-induced steat orrhea is not completely understood and does not result solely from the inhibitory effect of SST on pancreatic secretion [11,16,17].Therefore, the aim of the present study was to investigate the effects of SST infusion on bile flow and composition in man. …”

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confidence: 99%

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Pharmacological Effect of Somatostatin on Bile Secretion in Man

Marteau

Chrétien²,

Calmus³

et al. 1989

Digestion

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Somatostatin (SST) has been shown to induce cholestasis in the dog and in the rat. In man, it is still unknown whether SST modifies bile formation. The present study was undertaken to examine the influence of SST on bile secretion in man. Two volunteers who had a total external biliary fistula received 1-hour SST infusions (3.5 μg/kg/h). Bile flow, bile acid, phospholipid and cholesterol biliary outputs were measured before, during and 1 h after the infusion. The SST infusion was associated with a pronounced decrease in bile flow and in bile acid secretion and with an increase in bile cholesterol saturation. These findings suggest that SST has cholestatic properties in man as in other species. This may provide a rational explanation for the formation of gallstones and for the steatorrhea observed in patients with somatostatinomas or during therapeutic SST administration.

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Section: Discussionsupporting

confidence: 79%

mentioning

confidence: 99%

Pharmacological Effect of Somatostatin on Bile Secretion in Man

Marteau

Chrétien²,

Calmus³

et al. 1989

Digestion

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“…Additionally, a few cases with high somatostatin content of the tumour tissue and/or high plasma somatostatin levels, without the clinical picture of excessive hypersomatostatinaemia, have also been reported [3,24,25,30,38]. The patient described in the present paper exhibited many signs and symptoms of the somatostatinoma syndromes that have been reported so far and this study may offer a better understanding of the clinical pathophysiological findings in these cases.…”

Section: Introductionsupporting

confidence: 64%

Somatostatinoma syndrome. Clinical, morphological and metabolic features and therapeutic aspects

et al. 1983

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A case of somatostatinoma syndrome in a 30-year-old woman is presented. Basal levels of growth hormone and of pancreatic and gastric hormones were reduced and the response of growth hormone, insulin and C-peptide to stimuli such as arginine, glucose, glibenclamide and calcium was virtually abolished. Similarly, gastric acid secretion, pancreatic exocrine function and intestinal absorption were significantly reduced. On the other hand, basal and stimulated levels of adrenocorticotropic hormone (ACTH), luteinizing hormone (LH), follicle-stimulating hormone (FSH) and thyroid-stimulating hormone (TSH) were within the normal range. Plasma somatostatin-like immunoreactivity was increased to 600-2,000 pg/ml (normal: 88-140 pg/ml). Immunocytochemical studies demonstrated the presence of somatostatin immunoreactive material in the primary tumour in the head of the pancreas and in the liver metastases. In spite of two courses of chemotherapy with streptozotocin and 5-fluorouracil the patient died due to liver failure 5 months after the first admission to hospital.

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“…Many of the cases exhibit the triad of cholelithiasis, dyspepsia and diabetes mellitus encompassing the somatostatin syndrome. Additional features include weight loss, anaemia, diarrhoea and abdom inal pain [7,8,[11][12][13][14][15]. It remains to be shown whether these symptoms are due to somatostatin production by the tumour.…”

Section: Discussionmentioning

confidence: 99%

“…The tumour may be benign and resectable [14] but is usually malignant, and spread to the liver is common [7,[11][12][13][14][15], Extra pan creatic somatostatinomas have usually spread by the time of diagnosis [16,17], Detailed metabolic studies in patients with metastatic somatostatinoma have been re ported [11,18], In 1960, Joske [19] originally proposed that the atrophic jejunal mucosa in non-tropical sprue is a pre-carcinomatous lesion. Sub sequently, malignant intestinal lymphoma has been noted in up to 5-10% of cases in the UK [1,2,21,22], More recently it has been suggested that the particular histologic type associated with coeliac disease is malig nant histiocytosis [20,[23][24][25], Overall intes tinal malignancy may develop in as many as 14% of patients with coeliac disease [1], and the occasional patients may develop extraintestinal malignancies [2,20].…”

Section: Discussionmentioning

confidence: 99%

Malignant Pancreatic Somatostatinoma in a Patient with Dermatitis herpetiformis and Coeliac Disease

Levi¹,

Bjarnason²,

Swinson³

et al. 1988

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A case of malignant somatostatinoma is reported in a patient with long-standing dermatitis herpetiformis and coeliac disease. The patient had non-specific abdominal pain of several years duration and came to attention because of weight loss despite strict adherence to a gluten-free diet. Plasma somatostatin levels were raised, and laparotomy showed a pancreatic tumour with metastases, which on histology, electron microscopy and immunohistochemistry proved to be a somatostatinoma. After a promising initial response to streptozotocin, she died 30 months later. This is the first reported occurrence of a somatostatinoma in a patient with coeliac disease, adding to the growing list of neoplastic complications in this condition.

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Immunoreactive Somatostatin in Pancreatic Islet-Cell Carcinoma Accompanied by Ectopic A.C.T.H. Syndrome

Cited by 59 publications

References 5 publications

Pharmacological Effect of Somatostatin on Bile Secretion in Man

Pharmacological Effect of Somatostatin on Bile Secretion in Man

Somatostatinoma syndrome. Clinical, morphological and metabolic features and therapeutic aspects

Malignant Pancreatic Somatostatinoma in a Patient with Dermatitis herpetiformis and Coeliac Disease

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