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Somatostatin analogs and gallstones: A retrospective survey on a large series of acromegalic patients

Somatostatin analogs and gallstones: A retrospective survey on a large series of acromegalic... Context: Development of gallstones (GS) is reported during the use of somatostatin analogs (SA) that are at present the mainstay for the medical treatment of acromegaly. Objective: To review the prevalence and clinical and biochemical correlates of GS in acromegalic patients. Design and seting: Retrospective survey on hospital records in acromegalic patients followed up in the last 20 yr in tertiary referral centers. Patients: Four hundred and fifty-nine patients (272 females). Main outcome measures: According to SA use and GS occurrence, patients were divided in 4 groups: 1) treated with SA without GS (SA+GS−), 2) GS developed while on SA (SA+GS+), 3) GS without SA use (SA−GS+), 4) neither GS nor SA (SA−GS−). Results: Patients were unevenly distributed in the 4 groups: 232, 125, 38, 64, respectively, pointing to a prevalence of GS in acromegaly of 8.3% at diagnosis with an additional 35% developing GS during SA. GS occurred after 3 months-18 yr (median 3 yr) of SA treatment, were diagnosed after symptoms in 17.6%, were associated to steatosis, ultrasound biliary dilation, and biochemical cholestasis, in 25.6%, 12.8%, and 4% of patients, respectively. Ursodehoxicolic acid was administered after GS occurrence, causing their dissolution in 39% of patients after 3–48 months (median 12). Cholecystectomy was performed in 16.8% of patients in group 2. At multivariate analysis obesity, dyslipidemia, and SA treatment were independent predictors of GS onset, whereas gender and age were not. Conclusions: GS are a frequent occurrence in acromegalic patients treated with SA, may occur at any time, but are seldom symptomatic or prompt acute surgery. Obesity and dyslipidemia appear to play a major role in the occurrence of GS in acromegalic patients on SA treatment. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Endocrinological Investigation Springer Journals

Somatostatin analogs and gallstones: A retrospective survey on a large series of acromegalic patients

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References (67)

Publisher
Springer Journals
Copyright
Copyright © 2008 by Italian Society of Endocrinology (SIE)
Subject
Medicine & Public Health; Medicine/Public Health, general; Endocrinology; Metabolic Diseases
eISSN
1720-8386
DOI
10.1007/BF03346419
pmid
18852531
Publisher site
See Article on Publisher Site

Abstract

Context: Development of gallstones (GS) is reported during the use of somatostatin analogs (SA) that are at present the mainstay for the medical treatment of acromegaly. Objective: To review the prevalence and clinical and biochemical correlates of GS in acromegalic patients. Design and seting: Retrospective survey on hospital records in acromegalic patients followed up in the last 20 yr in tertiary referral centers. Patients: Four hundred and fifty-nine patients (272 females). Main outcome measures: According to SA use and GS occurrence, patients were divided in 4 groups: 1) treated with SA without GS (SA+GS−), 2) GS developed while on SA (SA+GS+), 3) GS without SA use (SA−GS+), 4) neither GS nor SA (SA−GS−). Results: Patients were unevenly distributed in the 4 groups: 232, 125, 38, 64, respectively, pointing to a prevalence of GS in acromegaly of 8.3% at diagnosis with an additional 35% developing GS during SA. GS occurred after 3 months-18 yr (median 3 yr) of SA treatment, were diagnosed after symptoms in 17.6%, were associated to steatosis, ultrasound biliary dilation, and biochemical cholestasis, in 25.6%, 12.8%, and 4% of patients, respectively. Ursodehoxicolic acid was administered after GS occurrence, causing their dissolution in 39% of patients after 3–48 months (median 12). Cholecystectomy was performed in 16.8% of patients in group 2. At multivariate analysis obesity, dyslipidemia, and SA treatment were independent predictors of GS onset, whereas gender and age were not. Conclusions: GS are a frequent occurrence in acromegalic patients treated with SA, may occur at any time, but are seldom symptomatic or prompt acute surgery. Obesity and dyslipidemia appear to play a major role in the occurrence of GS in acromegalic patients on SA treatment.

Journal

Journal of Endocrinological Investigation – Springer Journals

Published: Mar 27, 2014

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