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Necrotizing enterocolitis in neonates receiving octreotide for the management of congenital hyperinsulinism

Pablo Laje1, Lori Halaby, N Scott Adzick

  • 1Department of Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.

Pediatric Diabetes
|June 30, 2009
PubMed

Insights

Octreotide, used for congenital hyperinsulinism, may increase necrotizing enterocolitis risk in neonates. This study examines the association between octreotide treatment and this serious gastrointestinal complication.

Area of Science:

  • Neonatal Medicine
  • Pediatric Endocrinology
  • Gastroenterology

Background:

  • Octreotide, a somatostatin analog, has been a standard treatment for congenital hyperinsulinism since 1986.
  • While generally well-tolerated, octreotide is known to reduce splanchnic blood flow in a dose-dependent manner.
  • Concerns exist regarding octreotide's impact on gastrointestinal perfusion and potential adverse effects in neonates.

Observation:

  • This report details a series of patients treated at our institution.
  • We observed an association between octreotide use and the development of necrotizing enterocolitis.
  • This observation prompted a review of the existing literature on this topic.

Findings:

  • Octreotide administration in infants with congenital hyperinsulinism was associated with an increased incidence of necrotizing enterocolitis.
  • The reduction in splanchnic blood flow induced by octreotide may play a role in the pathogenesis of necrotizing enterocolitis.
  • Further investigation is warranted to understand the precise mechanisms and risk factors.

Implications:

  • The findings suggest a potential risk of necrotizing enterocolitis in neonates treated with octreotide for congenital hyperinsulinism.
  • Clinicians should be vigilant for signs of necrotizing enterocolitis in these patients.
  • This association may necessitate a re-evaluation of octreotide's role and risk-benefit profile in neonatal management.

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