Clinical outcomes of 20 Japanese patients with insulinomatreated with diazoxide

Endocrine journal

Hajime Izumiyama¹  Koshi Hashimoto²  Takanobu Yoshimoto³  Yoshihiro Niitsu⁴  Fuminori Satou⁵  Isao Minami⁶ 

[1] Department of Endocrinology and Metabolism, Tokyo Metropolitan Tama Medical Center, Tokyo 183-8524, Japan;Department of Endocrinology, Yokohama City Minato Red Cross Hospital, Kanagawa 231-8682, Japan;Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo 113-8510, Japan;Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan;Department of Molecular and Cellular Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan;Department of Preemptive Medicine and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan

关键词: Insulinoma;    Diazoxide;    Fluid retention;    Thrombocytopenia;   

DOI  :  10.1507/endocrj.EJ18-0353

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

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.

【 授权许可】

Unknown