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Effects of the long-acting somatostatin analogue SMS 201-995 in an infant with intractable diarrhea
U A Hunziker1, A Superti-Furga, M Zachmann
1Department of Paediatrics, University of Zurich, Switzerland.
Insights
The long-acting somatostatin analogue SMS 201-995 effectively reduced secretory diarrhea in an infant. Further research is needed to confirm the safety of this treatment for infants.
Area of Science:
- Pediatric Gastroenterology
- Endocrinology
Background:
- Intractable secretory diarrhea in infants poses significant treatment challenges.
- Conventional therapies may be ineffective for severe pediatric diarrhea.
Observation:
- A six-month-old infant with intractable diarrhea received SMS 201-995.
- Treatment lasted eight weeks, with dosage adjustments.
- The infant experienced reduced stool weight and sodium concentration.
Findings:
- SMS 201-995 positively impacted the secretory component of diarrhea.
- Significant reductions in growth hormone and moderate decreases in insulin, IGF-I, gastrin, pancreatic polypeptide, VIP, and neurotensin were observed.
- Linear growth inhibition occurred during treatment.
- The infant unexpectedly died from fulminant colitis, with the causal link to SMS 201-995 remaining unclear.
Implications:
- SMS 201-995 demonstrates efficacy in managing secretory diarrhea in infants.
- The safety profile in pediatric populations requires further investigation due to observed side effects and an unexplained fatality.
- Careful monitoring and additional studies are crucial before widespread pediatric use.
Abstract:
The long-acting somatostatin analogue SMS 201-995 was administered to a six-month-old infant with intractable diarrhea after failure of conventional treatment. During eight weeks of treatment, the secretory component of the diarrhea was positively influenced with a reduction of daily stool weight and stool sodium concentration. Plasma levels of growth hormone were markedly, and levels of insulin, IGF I, gastrin, pancreatic polypeptide, VIP, and neurotensin moderately decreased. Linear growth was also inhibited. The patient unexpectedly died from fulminant colitis at a time, when the dosage had been reduced from 18 to 3.5 micrograms/kg/day. The relationship, if any, between therapy with SMS 201-995 and the colitis remained unclear. It is concluded that SMS 201-995 can be effective in reducing secretory diarrhea in infants. However, further studies are necessary to assess the safety of its administration in this age group.