Related Experiment Videos
Intractable diarrhoea in a patient with vasoactive intestinal peptide-secreting neuroblastoma. Attempted control by
Insights
A child with neuroblastoma experienced severe diarrhea due to high vasoactive intestinal peptide (VIP) levels. Treatment with somatostatin failed to control the symptoms, despite reducing VIP, highlighting challenges in managing neuroblastoma-related complications.
Area of Science:
- Pediatric Oncology
- Endocrinology
- Gastroenterology
Background:
- Neuroblastoma is a common childhood cancer.
- Vasoactive intestinal peptide (VIP) can cause secretory diarrhea.
- Metastatic neuroblastoma can present with complex symptoms.
Observation:
- A 1.5-year-old child with metastatic neuroblastoma developed severe watery diarrhea.
- Elevated plasma vasoactive intestinal peptide (VIP) levels were identified as the cause.
- Standard treatments for the diarrhea were ineffective.
Findings:
- Somatostatin infusion was administered to control the diarrhea.
- The somatostatin infusion failed to resolve the diarrhea, despite significantly reducing serum VIP levels.
- This suggests VIP may not be the sole mediator of diarrhea in this context or other factors are involved.
Implications:
- Plasma VIP levels are important markers for neuroblastoma maturation and potential complications.
- Management of VIP-mediated diarrhea in neuroblastoma requires further investigation.
- Understanding treatment failures can guide future therapeutic strategies for rare neuroblastoma presentations.
Abstract:
A 1 1/2 year old child developed profuse watery diarrhoea, shown to be due to excessive plasma vasoactive intestinal peptide (VIP) levels, whilst on treatment for metastatic neuroblastoma. Because it was unresponsive to alternative treatment, an attempt was made to control the diarrhoea with a somatostatin infusion. The attempt failed despite the fact that serum VIP levels were substantially reduced. Possible reasons for failure are discussed and the importance of plasma VIP as a marker for maturation in neuroblastoma emphasised.