VIPoma medical therapy: Difference between revisions
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=Symptomatic treatment:= | =Symptomatic treatment:= | ||
*Initial treatment in patient with VIPoma is prompt replacement of fluid and electrolyte losses. The IV fluid of choice is isotonic normal saline with added potassium and bicarbonate as necessary. | *Initial treatment in patient with VIPoma is prompt replacement of fluid and electrolyte losses. The IV fluid of choice is isotonic normal saline with added potassium and bicarbonate as necessary. | ||
*[[Sandostatin|Somatostatin]] analogues like short acting octreotide (50-100mcg every 8 hours) are useful for controlling diarrhea by blocking the release of VIP. Octreotide is later replaced by longer acting depot preparation of somatostatin analogues like sandostatin (20 mg IM every 4 weeks) and Lanreotide (120mg subQ every 4 weeks) | |||
*[[Sandostatin]] or [[chemotherapy]] must be considered for malignant tumors. | *[[Sandostatin]] or [[chemotherapy]] must be considered for malignant tumors. | ||
*[[Steroids]] may be used to provide symptomatic relief. | *[[Steroids]] may be used to provide symptomatic relief. | ||
Revision as of 15:16, 8 January 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Madhu Sigdel M.B.B.S.[2]Parminder Dhingra, M.D. [3]
Overview
Initial treatment in patient with VIPoma is prompt replacement of fluid and correction of electrolyte imbalance and acid-base disturbance.[1]
Medical Therapy
Symptomatic treatment:
- Initial treatment in patient with VIPoma is prompt replacement of fluid and electrolyte losses. The IV fluid of choice is isotonic normal saline with added potassium and bicarbonate as necessary.
- Somatostatin analogues like short acting octreotide (50-100mcg every 8 hours) are useful for controlling diarrhea by blocking the release of VIP. Octreotide is later replaced by longer acting depot preparation of somatostatin analogues like sandostatin (20 mg IM every 4 weeks) and Lanreotide (120mg subQ every 4 weeks)
- Sandostatin or chemotherapy must be considered for malignant tumors.
- Steroids may be used to provide symptomatic relief.
- Prostaglandin synthesis inhibitors (e.g., indomethacin), phenothiazines, and lithium combination may be used.
- Long-term octreotide treatment not only controls the diarrhea in the patients with VIPoma but also may cause arrest or regression of the tumor.
References
- ↑ Vinik A. Vasoactive Intestinal Peptide Tumor (VIPoma) [Updated 2013 Nov 28]. In: De Groot LJ, Beck-Peccoz P, Chrousos G, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: http://www.ncbi.nlm.nih.gov/books/NBK278960/