Acute and long-term effects of octreotide in patients with ACTH-dependent cushing's syndrome

Nicholas James Younger Woodhouse, Samuel Dagogo-Jack, Mohammed Ahmed, Roman Judzewitsch

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

purpose: Octreotide is of proven efficacy in the management of patients with acromegaly, thyrotropin-secreting pituitary adenomas, and certain gastrointestinal tumors, but its effect in Cushing's syndrome is less clear. patients and methods: We studied 10 patients who presented with adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome, 3 of whom were previously adrenalectomized. Serum cortisol or ACTH levels were measured before and during the administration of octreotide 50 to 500 μg every 8 hours for 24 to 72 hours. results: Treatment was effective in four patients: serum cortisol levels decreased to within or below the normal range in Patients 1,2, and 3, and ACTH levels were substantially lowered in Patient 4, who had previously been adrenalectomized for a metastatic islet cell tumor. These responses were sustained during long-term treatment for 2 to 72 weeks. All four patients showed no evidence of a pituitary tumor on computed tomographic or magnetic resonance imaging and had proven (Patients 3 and 4) or presumed ectopic disease. Of the six patients who did not respond, four had pituitary tumors and two had presumed ectopic ACTH production. conclusion: We conclude that a short trial of octreotide is warranted in patients with ACTHdependent Cushing's syndrome who have no demonstrable pituitary tumor. A response to treatment should alert the physician to the possibility of an ectopic ACTH source and will identify patients whose disease may be controllable using octreotide.

Original languageEnglish (US)
Pages (from-to)305-308
Number of pages4
JournalThe American Journal of Medicine
Volume95
Issue number3
DOIs
StatePublished - Jan 1 1993
Externally publishedYes

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Octreotide
Cushing Syndrome
Adrenocorticotropic Hormone
Pituitary Neoplasms
Ectopic Hormones
Hydrocortisone
Islet Cell Adenoma
Acromegaly
Thyrotropin
Serum
Reference Values
Therapeutics
Magnetic Resonance Imaging
Physicians

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Acute and long-term effects of octreotide in patients with ACTH-dependent cushing's syndrome. / Woodhouse, Nicholas James Younger; Dagogo-Jack, Samuel; Ahmed, Mohammed; Judzewitsch, Roman.

In: The American Journal of Medicine, Vol. 95, No. 3, 01.01.1993, p. 305-308.

Research output: Contribution to journalArticle

Woodhouse, Nicholas James Younger ; Dagogo-Jack, Samuel ; Ahmed, Mohammed ; Judzewitsch, Roman. / Acute and long-term effects of octreotide in patients with ACTH-dependent cushing's syndrome. In: The American Journal of Medicine. 1993 ; Vol. 95, No. 3. pp. 305-308.
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