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Title: Hypoglycaemia and counterregulatory hormone responses in severe falciparum malaria: Treatment with Sandostatin
Authors: R. E. Phillips
C. Hatz
D. A. Warrell
R. E. Phillips
S. Looareesuwan
D. A. Warrell
M. E. Molyneux
University of Oxford
Mahidol University
Liverpool School of Tropical Medicine
Keywords: Medicine
Issue Date: 1-Jan-1993
Citation: QJM. Vol.86, No.4 (1993), 233-240
Abstract: The mechanism and response to treatment of severe life–threatening hypoglycaemia (plasma glucose 1.15±0.73 mM/I [±SD]) was studied in eight Thai patients with falciparum malaria. Plasma insulin concentrations were inappropriately high (range 1.0−21.8 mU/I), lactic acidosis was common (arterial blood lactic acid concentration 1.44—17.8 mM/I), but the glucose counterregulatory response, indicated by plasma cortisol, growth hormone, catecholamines and glucagon concentrations, was intact Hyperinsulinaemia was successfully treated in five patients by a continuous intravenous infusion of the long–acting somatostatin analogue Sandostatin (SMS 201—995), 50 μg/h. In volunteer studies a single intramuscular injection of Sandostatin (100 μg) suppressed quinine–induced hyperinsulinaemia within 15 min; this effect was maintained for 6 h. These results suggest that Sandostatin may be a safe and effective way of correcting the hyperinsulinaemic hypoglycaemia complicating quinine treatment of falciparum malaria. This treatment could be particularly useful in fluid–overloaded patients with recurrent hypoglycaemia despite dextrose infusions. © 1993 Oxford University Press.
ISSN: 14602393
Appears in Collections:Scopus 1991-2000

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