VIPoma medical therapy: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 10: Line 10:
*[[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|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)  
*[[Steroids]] are used in diarrhea of VIPoma refractory to somatostatin (prednisone 60 mg per day).
*[[Steroids]] are used in diarrhea of VIPoma refractory to somatostatin (prednisone 60 mg per day).
*Sunitinib a tyrosin kinase inhibitor has some evidence of symptomatic and biochemical control in somatostatin analogue resistant VIPoma.<ref name="pmid27461388">{{cite journal| author=Dimitriadis GK, Weickert MO, Randeva HS, Kaltsas G, Grossman A| title=Medical management of secretory syndromes related to gastroenteropancreatic neuroendocrine tumours. | journal=Endocr Relat Cancer | year= 2016 | volume= 23 | issue= 9 | pages= R423-36 | pmid=27461388 | doi=10.1530/ERC-16-0200 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27461388  }}</ref>
*Prostaglandin synthesis inhibitors (e.g., [[indomethacin]]), [[phenothiazines]], and [[lithium]] combination may be used.
*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.
*Long-term [[octreotide]] treatment not only controls the [[diarrhea]] in the patients with VIPoma but also may cause arrest or regression of the tumor.

Revision as of 18:02, 8 January 2018

VIPoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating VIPoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

VIPoma medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of VIPoma medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on VIPoma medical therapy

CDC on VIPoma medical therapy

VIPoma medical therapy in the news

Blogs on VIPoma medical therapy

Directions to Hospitals Treating VIPoma

Risk calculators and risk factors for VIPoma medical therapy

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)
  • Steroids are used in diarrhea of VIPoma refractory to somatostatin (prednisone 60 mg per day).
  • Sunitinib a tyrosin kinase inhibitor has some evidence of symptomatic and biochemical control in somatostatin analogue resistant VIPoma.[2]
  • 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

  1. 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/
  2. Dimitriadis GK, Weickert MO, Randeva HS, Kaltsas G, Grossman A (2016). "Medical management of secretory syndromes related to gastroenteropancreatic neuroendocrine tumours". Endocr Relat Cancer. 23 (9): R423–36. doi:10.1530/ERC-16-0200. PMID 27461388.


Template:WikiDoc Sources