Chronic subcutaneous octreotide decreases gastrointestinal blood loss in blue rubber-bleb nevus syndrome

Daniela Gonzalez, Ben J. Elizondo, Sara Haslag, George Buchanan, J. Steven Burdick, Philip C. Guzzetta, Barry A. Hicks, John M. Andersen

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Background: A patient affected by blue rubber-bleb nevus syndrome had chronic gastrointestinal bleeding requiring weekly blood transfusions. Despite multiple surgical and endoscopic procedures to treat the venous malformations, the patient continued to bleed primarily from lesions in the small bowel. Therefore, this patient was treated with octreotide, a somatostatin analog known to decrease splanchnic blood flow and that is used for acute and chronic gastrointestinal bleeding. Methods: Octreotide therapy, 5.7 μg/kg subcutaneously twice daily, was initiated, and the patient was followed up clinically. Complete blood counts, blood glucose concentration, pancreatic enzyme concentration, liver function tests, and growth hormone concentration were monitored during treatments. Results: During the 4 weeks after initiation of octreotide therapy, hemoglobin concentration was maintained without the need for transfusions. Octreotide decreased the patient's monthly need for blood transfusion from 52 ± 7 mL · kg-1 · mo-1 of packed red blood cells to 23 ± 7 mL · kg-1 · mo-1. She had no detectable side effects or growth inhibition. Other medical interventions including -εaminocaproic acid, nadolol, and total parenteral nutrition with bowel rest were not as effective as octreotide alone. Conclusion: Octreotide decreased the patient's need for blood transfusions. Possible mechanisms include altering blood flow to the gastrointestinal tract and direct effects on the venous malformations.

Original languageEnglish (US)
Pages (from-to)183-188
Number of pages6
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume33
Issue number2
DOIs
StatePublished - 2001

Fingerprint

octreotide
Octreotide
rubber
blood transfusion
blood
Blood Transfusion
blood flow
hemorrhage
Nadolol
Hemorrhage
Aminocaproic Acid
therapeutics
somatostatin
Viscera
Blood Cell Count
Total Parenteral Nutrition
Liver Function Tests
total parenteral nutrition
liver function
Somatostatin

Keywords

  • Blue rubber-bleb nevus syndrome
  • Chronic gastrointestinal bleeding
  • Octreotide
  • Venous malformations

ASJC Scopus subject areas

  • Gastroenterology
  • Histology
  • Medicine (miscellaneous)
  • Food Science
  • Pediatrics, Perinatology, and Child Health

Cite this

Chronic subcutaneous octreotide decreases gastrointestinal blood loss in blue rubber-bleb nevus syndrome. / Gonzalez, Daniela; Elizondo, Ben J.; Haslag, Sara; Buchanan, George; Burdick, J. Steven; Guzzetta, Philip C.; Hicks, Barry A.; Andersen, John M.

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 33, No. 2, 2001, p. 183-188.

Research output: Contribution to journalArticle

@article{31f72e2e4eb345618c9a5cae56b283f5,
title = "Chronic subcutaneous octreotide decreases gastrointestinal blood loss in blue rubber-bleb nevus syndrome",
abstract = "Background: A patient affected by blue rubber-bleb nevus syndrome had chronic gastrointestinal bleeding requiring weekly blood transfusions. Despite multiple surgical and endoscopic procedures to treat the venous malformations, the patient continued to bleed primarily from lesions in the small bowel. Therefore, this patient was treated with octreotide, a somatostatin analog known to decrease splanchnic blood flow and that is used for acute and chronic gastrointestinal bleeding. Methods: Octreotide therapy, 5.7 μg/kg subcutaneously twice daily, was initiated, and the patient was followed up clinically. Complete blood counts, blood glucose concentration, pancreatic enzyme concentration, liver function tests, and growth hormone concentration were monitored during treatments. Results: During the 4 weeks after initiation of octreotide therapy, hemoglobin concentration was maintained without the need for transfusions. Octreotide decreased the patient's monthly need for blood transfusion from 52 ± 7 mL · kg-1 · mo-1 of packed red blood cells to 23 ± 7 mL · kg-1 · mo-1. She had no detectable side effects or growth inhibition. Other medical interventions including -εaminocaproic acid, nadolol, and total parenteral nutrition with bowel rest were not as effective as octreotide alone. Conclusion: Octreotide decreased the patient's need for blood transfusions. Possible mechanisms include altering blood flow to the gastrointestinal tract and direct effects on the venous malformations.",
keywords = "Blue rubber-bleb nevus syndrome, Chronic gastrointestinal bleeding, Octreotide, Venous malformations",
author = "Daniela Gonzalez and Elizondo, {Ben J.} and Sara Haslag and George Buchanan and Burdick, {J. Steven} and Guzzetta, {Philip C.} and Hicks, {Barry A.} and Andersen, {John M.}",
year = "2001",
doi = "10.1097/00005176-200108000-00017",
language = "English (US)",
volume = "33",
pages = "183--188",
journal = "Journal of Pediatric Gastroenterology and Nutrition",
issn = "0277-2116",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Chronic subcutaneous octreotide decreases gastrointestinal blood loss in blue rubber-bleb nevus syndrome

AU - Gonzalez, Daniela

AU - Elizondo, Ben J.

AU - Haslag, Sara

AU - Buchanan, George

AU - Burdick, J. Steven

AU - Guzzetta, Philip C.

AU - Hicks, Barry A.

AU - Andersen, John M.

PY - 2001

Y1 - 2001

N2 - Background: A patient affected by blue rubber-bleb nevus syndrome had chronic gastrointestinal bleeding requiring weekly blood transfusions. Despite multiple surgical and endoscopic procedures to treat the venous malformations, the patient continued to bleed primarily from lesions in the small bowel. Therefore, this patient was treated with octreotide, a somatostatin analog known to decrease splanchnic blood flow and that is used for acute and chronic gastrointestinal bleeding. Methods: Octreotide therapy, 5.7 μg/kg subcutaneously twice daily, was initiated, and the patient was followed up clinically. Complete blood counts, blood glucose concentration, pancreatic enzyme concentration, liver function tests, and growth hormone concentration were monitored during treatments. Results: During the 4 weeks after initiation of octreotide therapy, hemoglobin concentration was maintained without the need for transfusions. Octreotide decreased the patient's monthly need for blood transfusion from 52 ± 7 mL · kg-1 · mo-1 of packed red blood cells to 23 ± 7 mL · kg-1 · mo-1. She had no detectable side effects or growth inhibition. Other medical interventions including -εaminocaproic acid, nadolol, and total parenteral nutrition with bowel rest were not as effective as octreotide alone. Conclusion: Octreotide decreased the patient's need for blood transfusions. Possible mechanisms include altering blood flow to the gastrointestinal tract and direct effects on the venous malformations.

AB - Background: A patient affected by blue rubber-bleb nevus syndrome had chronic gastrointestinal bleeding requiring weekly blood transfusions. Despite multiple surgical and endoscopic procedures to treat the venous malformations, the patient continued to bleed primarily from lesions in the small bowel. Therefore, this patient was treated with octreotide, a somatostatin analog known to decrease splanchnic blood flow and that is used for acute and chronic gastrointestinal bleeding. Methods: Octreotide therapy, 5.7 μg/kg subcutaneously twice daily, was initiated, and the patient was followed up clinically. Complete blood counts, blood glucose concentration, pancreatic enzyme concentration, liver function tests, and growth hormone concentration were monitored during treatments. Results: During the 4 weeks after initiation of octreotide therapy, hemoglobin concentration was maintained without the need for transfusions. Octreotide decreased the patient's monthly need for blood transfusion from 52 ± 7 mL · kg-1 · mo-1 of packed red blood cells to 23 ± 7 mL · kg-1 · mo-1. She had no detectable side effects or growth inhibition. Other medical interventions including -εaminocaproic acid, nadolol, and total parenteral nutrition with bowel rest were not as effective as octreotide alone. Conclusion: Octreotide decreased the patient's need for blood transfusions. Possible mechanisms include altering blood flow to the gastrointestinal tract and direct effects on the venous malformations.

KW - Blue rubber-bleb nevus syndrome

KW - Chronic gastrointestinal bleeding

KW - Octreotide

KW - Venous malformations

UR - http://www.scopus.com/inward/record.url?scp=0034861372&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034861372&partnerID=8YFLogxK

U2 - 10.1097/00005176-200108000-00017

DO - 10.1097/00005176-200108000-00017

M3 - Article

C2 - 11568521

AN - SCOPUS:0034861372

VL - 33

SP - 183

EP - 188

JO - Journal of Pediatric Gastroenterology and Nutrition

JF - Journal of Pediatric Gastroenterology and Nutrition

SN - 0277-2116

IS - 2

ER -