Octreotide, a somatostatin analogue, in the treatment of chylothorax associated with idiopathic fibrosing mediastinitis.
Octreotide, a somatostatin analogue, in the treatment of chylothorax associated with idiopathic fibrosing mediastinitis.
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奥曲肽是一种生长抑素类似物，用于治疗与特发性纤维化纵隔炎相关的乳糜胸。
DOI：
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发表时间：
2010
影响因子：
2.2
通讯作者：
M. Mishima
中科院分区：
文献类型：
--
作者：
Y. Togashi;Y. H. Kim;R. Miyahara;K. Irisa;Y. Sakamori;K. Masago;T. Mio;H. Date;M. Mishima
纤维性纵隔炎（FM）是一种罕见的良性疾病，其特征是纵隔过度纤维化反应。FM与多种疾病相关，包括荚膜组织胞浆菌感染和IgG 4相关疾病，并可能损害气道、大血管和其他纵隔结构。乳糜胸不是FM的常见表现，并且对于FM或乳糜胸没有标准的治疗方法。然而，最近，生长抑素和奥曲肽，生长抑素类似物，被成功地用于治疗乳糜胸由于各种原因，他们被认为是公认的治疗乳糜胸的干预措施。在这里，我们提出了一个28岁的日本男子乳糜胸由于特发性调频，谁是成功治疗奥曲肽。患者因劳力性呼吸困难来我院就诊。入院时，胸部计算机断层扫描显示心包积液，双侧胸腔积液和纵隔肿块。右侧胸腔积液呈乳糜样，甘油三酯水平为253 mg/dl。纵膈腔肿块的活检标本显示胶原纤维和成纤维细胞伴中度淋巴细胞浸润。活检标本中未培养出真菌和细菌。类固醇治疗无效。然后患者接受皮下奥曲肽治疗（100微克，每日三次）。开始治疗后5天，引流的胸膜液从约1，000 ml/天降至约150 ml/天。奥曲肽治疗2周后纵隔肿块缩小。出院后，患者已接受奥曲肽治疗6个月，无严重不良事件。我们建议奥曲肽作为FM的治疗选择。
Fibrosing mediastinitis (FM) is a rare benign disorder that is characterized by excessive fibrotic reactions in the mediastinum. FM is associated with various diseases, including Histoplasma capsulatum infection and IgG4-related disease, and may compromise the airways, great vessels, and other mediastinal structures. Chylothorax is not a common manifestation of FM, and there is no standard treatment for FM or chylothorax. Recently, however, somatostatin and octreotide, a somatostatin analogue, were successfully used for the treatment of chylothorax due to various causes, and they are considered as putative therapeutic interventions for chylothorax. Here, we present a 28-year-old Japanese man with chylothorax due to idiopathic FM, who was successfully treated with octreotide. The patient visited our hospital because of dyspnea on exertion. On admission, chest computed tomography revealed pericardial effusion, bilateral pleural effusion, and a mass in the mediastinum. The right pleural effusion appeared chylous, with the triglyceride level of 253 mg/dl. The biopsy specimen from the mediastinal mass showed collagenous fibers and fibroblasts with moderate infiltration of lymphocytes. Neither fungi nor bacteria were cultured from the biopsy specimen. Steroid therapy was not effective. The patient was then treated with subcutaneous octreotide (100 microg three times daily). Five days after starting the treatment, the drained pleural fluid was decreased to approximately 150 ml/day from approximately 1,000 ml/day. The mediastinal mass decreased in size 2 weeks after the initiation of octreotide treatment. After discharge, the patient has received octreotide treatment for 6 months without serious adverse events. We suggest octreotide as a treatment option for FM.
短期奥曲肽给药对受辐射大鼠肠道中慢性组织损伤、转化生长因子β (TGF-β) 过度表达和胶原蛋白积累的影响。
DOI：
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发表时间：
2001
期刊：
The Journal of pharmacology and experimental therapeutics
影响因子：
--
作者：
Wang,J;Zheng,H;Hauer-Jensen,M
通讯作者：
Hauer-Jensen,M