[Octreotide therapy in multiple endocrine neoplasia type-1]

In multiplex endocrine neoplasia type 1, hyperparathyroidism, pancreas tumor and pituitary tumor are generally combined. The authors report two patients with this syndrome, in whom overproduction of parathormone and gastrin was detected, and parathyroid adenomas were detected by parathyroid scintigraphy. Pancreatic adenomas were discovered with somatostatin receptor scintigraphy or magnetic resonance imaging. Hyperprolactinaemia without pituitary tumor in the first case, and prolactinoma in the second case, as well as nonfunctioning adrenal adenomas in both cases were also observed. After several unsuccessful surgical interventions a long-term octreotide (Sandostatin, Novartis) treatment was started; in the first patient subcutaneous injection was given for 6 months, then the treatment was continued with the long-acting intramuscular preparation (Sandostatin LAR, Novartis). The second patient received long-acting octreotide from the beginning of medical therapy. The authors intended to obtain data about the effects of this therapy on all overproduced hormones. In the first case, a 6-months treatment with subcutaneous octreotide surprisingly resulted not only in a decrease of serum gastrin, but also in that of parathormone level. In the second case, serum gastrin was normalized, but parathormone did not change. The levels of prolactin and adrenocortical hormones were not affected. At present, the two patients are without any symptoms of their disease.