Severe hypertension induced by the long-acting somatostatin analogue sandostatin LAR in a patient with diabetic autonomic neuropathy

A 26-yr-old woman with type 1 diabetes and severe symptomatic autonomic neu ropathy was treated with the long-acting somatostatin analogue Sandostatin LAR for intractable diarrhea. Her diarrhea had previously been successfully managed with three daily injections of octreotide without adverse conseque nces. She was given a single dose of Sandostatin LAR and within 2 weeks rep orted the development of increasingly frequent and severe headaches. Three weeks after the injection, she was admitted to hospital with severe hyperte nsion, which eventually resolved with the administration of antihypertensiv e agents. No other underlying cause of the hypertension was discovered. Rec hallenge of the patient with octreotide resulted in a transient hypertensiv e episode, which lasted 3 h. Severe hypertension, therefore, seems to be a possible adverse effect of treatment of diabetic diarrhea with somatostatin analogues, which should be used with great caution in subjects with severe autonomic dysfunction.