Clinical outcomes of 20 Japanese patients with insulinoma treated with diazoxide
| Autor: | Isao Minami, Takanobu Yoshimoto, Minoru Tanabe, Kazuki Ota, Hajime Izumiyama, Tetsuya Yamada, Fuminori Satou, Koshi Hashimoto, Atsushi Kudo, Motoyoshi Tsujino, Yoshihiro Niitsu, Yoshihiro Ogawa |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Antineoplastic Agents Gastroenterology 03 medical and health sciences Young Adult 0302 clinical medicine Endocrinology Japan Internal medicine Diazoxide Medicine Humans Platelet Adverse effect Insulinoma Aged Retrospective Studies Aged 80 and over Tumor size Medical treatment business.industry Medical record Middle Aged medicine.disease Effective dose (pharmacology) Pancreatic Neoplasms Treatment Outcome 030220 oncology & carcinogenesis Female business medicine.drug |
| Zdroj: | Endocrine journal. 66(2) |
| ISSN: | 1348-4540 |
| Popis: | Diazoxide is recognized as an effective medical treatment for insulinoma. However, due to its adverse effects, such as fluid retention, it is sometimes difficult to employ diazoxide at an effective dose in clinical practice. This study aimed to clarify the clinical factors, which may affect efficacy and safety of the diazoxide treatment. We retrospectively evaluated the medical records of 20 patients with insulinoma including 4 malignant cases. The patients were divided into two groups according to the presence or absence of favorable outcomes or adverse effects, and the clinical features of both groups were compared. Diazoxide was effective and ineffective in each 9 patients, respectively. In other 2 cases, the efficacy could not be determined. In the effective group, all patients had benign insulinoma. Additionally, the tumor size determined by imaging test was tended to smaller than the ineffective group but not statistically significant when malignant cases were excluded (p = 0.065). Fluid retention was observed more frequently in females than in males (p = 0.025). Five patients displayed unacceptable thrombocytopenia within a few weeks after the administration of diazoxide. In these patients, the diazoxide dose was significantly higher than that in the other patients [400 mg/day (250-500 mg/day) vs. 225 mg/day (50-425 mg/day), p = 0.027]. These findings may be informative in determining the indication and dose of diazoxide against insulinoma. In addition, a careful evaluation of platelet count would be required for a few weeks after the initiation of diazoxide treatment. |
| Databáze: | OpenAIRE |
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