HEPATOBILIARY COMPLICATIONS OF OCTREOTIDE TREATMENT IN CHILDREN WITH TALL STATURE

Abstract 14 A somatostatin analog, octreotide (Sandostatin®), was used in a multicenter and open study to reduce final height in 29 children (15 boys, 14.1 ± 1 yr, 14 girls, 12.2 ± 0.1 yr) with tall stature (height prediction >190 cm in boys or >180 cm in girls). Patients received octreotide 250 µg s.c., b.i.d., for a total duration of 1.9 ± 0.5 yr (boys) or 2.3 ± 0.5 yr (girls). Hepatobiliary side-effects were systematically monitored by ultrasound before treatment and every 6 months thereafter and occurred in 6 children (3 boys, 3 girls) i.e. 21%. In 5 cases, hepatobiliary manifestations were clinically asymptomatic and consisted of gall-bladder sludge and microlithiasis (boy, after 34 mo treatment), 5 mm gall-bladder lithiasis (girl, 18 mo), gall-bladder microlithiasis (2 girls, 6 mo) and solely intra-hepatic lithiasis (boy, 14 mo). A boy with abdominal pain (after 11 mo) exhibited numerous gall-bladder micro-lithiasis and transient biological hepatic dysfunction (10 fold increase of alcaline phosphatase and transaminases). Treatment with ursodeoxycholic acid (10mg/Kg/d) was undertaken, which resulted, despite Sandostatin continuation, in the disappearance of lithiasis in 4 (after 0.5, 3, 3 and 6 mo), including the child with clinical and biological symptoms. The lithiasis persisted after 6 mo in 2, among whom 1 with a poor adhesion to ursodeoxycholic acid treatment. We conclude that octreotide may induce biliary lithiasis in 21 % of treated children and that ursodeoxycholic acid treatment proves efficient in most cases. HEPATOLOGY