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Pancreatic Cholera Syndrome: Effect of a Synthetic Somatostatin Analog on Intestinal Water and Ion Transport

WILLIAM C. SANTANGELO, M.D.; THOMAS M. O'DORISIO, M.D.; JONG G. KIM, M.D.; GENE SEVERINO, M.D.; and GUENTER J. KREJS, M.D.
[+] Article and Author Information

Grant support: in part by grants 1-RO1-AM-28390-03 and 5-MO1-RR-00633 from the United States Public Health Service.

▸Requests for reprints should be addressed to Guenter J. Krejs, M.D.; Department of Internal Medicine, University of Texas Health Science Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75235.


Dallas, Texas; Columbus, Ohio; and Peoria, Arizona


© 1985 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1985;103(3):363-367. doi:10.7326/0003-4819-103-3-363
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The effect of a synthetic somatostatin analog was studied in a patient with severe secretory diarrhea due to pancreatic cholera syndrome. Basal intestinal perfusion studies indicated an absence of water and sodium absorption, and active chloride secretion in the small bowel. Intravenous administration of the somatostatin analog (1 µg/kg · h) changed zero net water movement to absorption (122 mL/30 cm of the jejunum per hour). Chloride secretion changed to absorption (5.0 to 7.9 meq/30 cm · h), and plasma vasoactive intestinal polypeptide concentration was reduced from 330 to 45 pmol/L (normal, less than 51). When the analog was given subcutaneously, 100 µg twice daily, stool weight decreased, and plasma vasoactive intestinal polypeptide concentration fell toward the normal range (67 pmol/L). Plasma concentration of pancreatic polypeptide was initially elevated and dropped during intravenous infusion of somatostatin analog but returned to baseline on maintenance therapy with the analog delivered subcutaneously. The patient has not had further diarrhea during 9 months of therapy.

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