A gonadotropin releasing hormone analogue prevents cyclical attacks of porphyria

Article Abstract:

Acute intermittent porphyria is a rare inherited metabolic disorder characterized by excessive excretion of porphyrins (cellular components which help form hemoglobin), abdominal pain, nervous system disorders, and sensitivity to light. Porphyrins are naturally occurring, nitrogen-containing compounds that are involved in cellular respiration, a life-sustaining process in which energy is produced in the cell after the consumption of oxygen. Sulfonamides, barbiturates, and other drugs can trigger attacks of porphyria, and hormones can influence the development of symptoms associated with this disorder. In addition, acute intermittent porphyria can worsen before menstruation. Gonadotropin releasing hormone analogues decrease the secretion of luteinizing hormone and follicle-stimulating hormone, which are involved in triggering ovulation, the release of the egg during the menstrual cycle. A gonadotropin releasing hormone analogue administered into the nose or beneath the skin for up to 26 months reduced or eliminated premenstrual attacks of acute intermittent porphyria in six women, causing only minor side effects. Some patients required changes in the dose or method of administering the drug. These results show that treatment with a gonadotropin releasing hormone analogue will prevent premenstrual attacks of acute intermittent porphyria resulting from changes in hormones occurring during the menstrual cycle. In addition, this hormone analogue provides a safe alternative to treatment with steroid agents, which may actually trigger attacks of this hereditary disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Hormone therapy, Gonadotropin releasing hormone, Gonadorelin, Porphyria

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Reversible shrinkage of a growth hormone-secreting pituitary adenoma by a long-acting somatostatin analogue, octreotide

Article Abstract:

Octreotide acetate (SMS-201-995) was used to treat a patient who had developed acromegaly, a condition of elongated and enlarged bones of the head, jaws and extremities, as a result of a cancerous tumor in his pituitary gland. Octreotide acetate is a medication similar to a chemical that is produced in the brain's hypothalamus and in the pancreas and that prevents the release of both growth hormone and insulin. Administration of octreotide effectively suppressed both growth hormone and an insulin-like growth factor and reduced the patient's symptoms. Magnetic resonance imaging (MRI) revealed a 70 percent shrinkage in the pituitary tumor after four months of therapy. When the medication was not given for four weeks, a second MRI showed re-growth of the tumor. Improvement in the patient's condition has continued since octreotide therapy was restarted. The findings suggest that octreotide may provide considerable eradication of cancerous tumors that initiate growth hormone secretion.

Health aspects, Somatotropin, Chemotherapy, Adenoma, Acromegaly, Pituitary gland tumors, Pituitary tumors, Octreotide acetate

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Reversible common variable immunodeficiency syndrome induced by phenytoin

Article Abstract:

Panhypogammaglobulinemia is a deficiency of all classes of gamma globulin, which are proteins formed in the blood which enable the body to resist infection. Panhypogammaglobulinemia is caused by the medication phenytoin (dilantin) is rare. The case of a patient is described who developed panhypogammalobulinemia while being treated with phenytoin in addition to corticosteroids. At the same time the patient developed recurrent pneumonia, a high number of eosinophilia white blood cells and a rash. The illness mimicked the common immunodeficiency syndrome. Immunoglobulin levels returned to normal during a period of several months after the phenytoin was stopped. Similar symptoms in a patient receiving this medication should lead to a prompt evaluation of the patient's immunologic status.

Diagnosis, Complications and side effects, Immunological deficiency syndromes, Immunologic deficiency syndromes, Phenytoin, Agammaglobulinemia

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