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Octreotide-induced hepatitis in a child with persistent hyperinsulinemia hypoglycemia of infancy

Josef Ben-Ari1, Meidad Greenberg, Dan Nemet

  • 1Department of Pediatric, Tel-Aviv University, Israel.

Journal of Pediatric Endocrinology & Metabolism : JPEM
|January 19, 2013
PubMed

Insights

Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is a genetic disorder. A rare case shows octreotide treatment can cause liver injury (hepatitis), especially at high doses, necessitating liver function monitoring.

Area of Science:

  • Pediatric Endocrinology
  • Hepatology
  • Clinical Pharmacology

Background:

  • Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is a genetic disorder causing abnormal insulin secretion and persistent hypoglycemia.
  • Diazoxide is a first-line treatment, with octreotide used as a second-line therapy for refractory cases.
  • Somatostatin analogs like octreotide are crucial in managing PHHI when other treatments fail.

Observation:

  • This report details a rare instance of octreotide-induced hepatitis in an infant undergoing prolonged treatment for PHHI.
  • The adverse hepatic event occurred following extended octreotide administration.
  • Hepatotoxicity appears linked to high octreotide doses or dose escalations.

Findings:

  • Octreotide therapy, while effective for PHHI, carries a risk of liver injury.
  • Hepatitis developed in this infant after prolonged use of octreotide.
  • Prompt discontinuation of octreotide led to the resolution of hepatitis.

Implications:

  • Routine liver function tests are recommended for infants receiving long-term octreotide treatment for PHHI.
  • Awareness of potential octreotide-induced hepatitis is crucial for pediatric endocrinologists and hepatologists.
  • Early detection and cessation of octreotide can prevent severe liver complications in PHHI patients.

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