Intestinal Lymphangiectasia Medication

  • Author: Anthony E Martin, MD; Chief Editor: Julian Katz, MD   more...
 
Updated: Jan 5, 2012
 

Medication Summary

Two case reports document the use of octreotide to control symptoms in refractory cases. In the first report, octreotide improved symptoms, findings on scintigraphy and endoscopy, and histology of the duodenum in a patient with intestinal lymphangiectasia. The second report showed that octreotide at 200 mcg bid resulted in reduction in enteric protein loss from 16% to 4.1% in 5 days, and albumin infusions, which were necessary to maintain an acceptable level, were eliminated in a single patient with intestinal lymphangiectasia. Additional cases have been reported with the successful use of octreotide, including the long-acting formulation (LAR).

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Somatostatin analogs

Class Summary

Used to inhibit effects of GI hormones.

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Octreotide (Sandostatin)

 

Acts in a similar fashion to the hormone somatostatin. Very potent inhibitor of growth hormone, glucagon, and insulin. Markedly decreases splanchnic blood flow and suppresses LH response to GnRH. Has a strong suppressive effect of GI hormones, including gastrin, motilin, secretin, and pancreatic polypeptide. Because of its suppressive effects on GI tract, octreotide is used in a variety of GI diseases, such as VIPoma and carcinoid tumors.

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Antihemophilic agents

Class Summary

Agents like tranexamic acid can competitively inhibit activation of plasminogen to plasmin, diminishing bleeding.

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Tranexamic acid (Cyklokapron)

 

Inhibits plasminogen activators, interfering with fibrinolysis.

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Contributor Information and Disclosures
Author

Anthony E Martin, MD  Associate Professor of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, Fellowship Training Program Director, University of Louisville School of Medicine

Anthony E Martin, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Physicians, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy, Association of Military Surgeons of the US, Kentucky Medical Association, and Special Operations Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Richard Wright, MD  Professor and Chief, Department of Medicine, Division of Gastroenterology/Hepatology, University of Louisville School of Medicine

Richard Wright, MD is a member of the following medical societies: American College of Physician Executives, American College of Physicians, American Gastroenterological Association, American Medical Association, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Specialty Editor Board

Rajeev Vasudeva, MD, FACG  Clinical Professor of Medicine, Consultants in Gastroenterology, University of South Carolina School of Medicine

Rajeev Vasudeva, MD, FACG is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy, Columbia Medical Society, South Carolina Gastroenterology Association, and South Carolina Medical Association

Disclosure: Pricara Honoraria Speaking and teaching; UCB Consulting fee Consulting

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Oscar S Brann, MD, FACP  Associate Clinical Professor, Department of Medicine, University of California at San Diego; Consulting Staff, Mecklenburg Medical Group

Oscar S Brann, MD, FACP is a member of the following medical societies: American Gastroenterological Association

Disclosure: Nothing to disclose.

Alex J Mechaber, MD, FACP  Senior Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD  Clinical Professor of Medicine, Drexel University College of Medicine

Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law, Medicine & Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Additional Contributors

We wish to thank Raoul Joubran, MD, for his previous contributions to this article.

References

  1. Vignes S, Carcelain G. Increased surface receptor Fas (CD95) levels on CD4+ lymphocytes in patients with primary intestinal lymphangiectasia. Scand J Gastroenterol. 2009;44(2):252-6. [Medline].

  2. Vignes S, Bellanger J. Primary intestinal lymphangiectasia (Waldmann's disease). Orphanet J Rare Dis. Feb 22 2008;3:5. [Medline].

  3. Freeman HJ, Nimmo M. Intestinal lymphangiectasia in adults. World J Gastrointest Oncol. Feb 15 2011;3(2):19-23. [Medline]. [Full Text].

  4. Safatle-Ribeiro AV, Iriya K, Couto DS, et al. Secondary lymphangiectasia of the small bowel: utility of double balloon enteroscopy for diagnosis and management. Dig Dis. 2008;26(4):383-6. [Medline].

  5. Takenaka H, Ohmiya N, Hirooka Y, Nakamura M, Ohno E, Miyahara R, et al. Endoscopic and Imaging Findings in Protein-losing Enteropathy. J Clin Gastroenterol. Dec 1 2011;[Medline].

  6. Oh TG, Chung JW, Kim HM, Han SJ, Lee JS, Park JY, et al. Primary intestinal lymphangiectasia diagnosed by capsule endoscopy and double balloon enteroscopy. World J Gastrointest Endosc. Nov 16 2011;3(11):235-40. [Medline]. [Full Text].

  7. Desai AP, Guvenc BH, Carachi R. Evidence for medium chain triglycerides in the treatment of primary intestinal lymphangiectasia. Eur J Pediatr Surg. Aug 2009;19(4):241-5. [Medline].

  8. Kim NR, Lee SK, Suh YL. Primary intestinal lymphangiectasia successfully treated by segmental resections of small bowel. J Pediatr Surg. Oct 2009;44(10):e13-7. [Medline].

  9. Aoyagi K, Iida M, Yao T, Matsui T, Okada M, Fujishima M. Intestinal lymphangiectasia: value of double-contrast radiographic study. Clin Radiol. Nov 1994;49(11):814-9. [Medline].

  10. Aoyagi K, Iida M, Yao T, Matsui T, Okada M, Oh K. Characteristic endoscopic features of intestinal lymphangiectasia: correlation with histological findings. Hepatogastroenterology. Jan-Feb 1997;44(13):133-8. [Medline].

  11. Ballinger AB, Farthing MJ. Octreotide in the treatment of intestinal lymphangiectasia. Eur J Gastroenterol Hepatol. Aug 1998;10(8):699-702. [Medline].

  12. Bouhnik Y, Etienney I, Nemeth J, Thevenot T, Lavergne-Slove A, Matuchansky C. Very late onset small intestinal B cell lymphoma associated with primary intestinal lymphangiectasia and diffuse cutaneous warts. Gut. Aug 2000;47(2):296-300. [Medline].

  13. Filik L, Oguz P, Koksal A, Koklu S, Sahin B. A case with intestinal lymphangiectasia successfully treated with slow-release octreotide. Dig Liver Dis. Oct 2004;36(10):687-90. [Medline].

  14. Fuss IJ, Strober W, Cuccherini BA, Pearlstein GR, Bossuyt X, Brown M, et al. Intestinal lymphangiectasia, a disease characterized by selective loss of naive CD45RA+ lymphocytes into the gastrointestinal tract. Eur J Immunol. Dec 1998;28(12):4275-85. [Medline].

  15. Kuroiwa G, Takayama T, Sato Y, Takahashi Y, Fujita T, Nobuoka A, et al. Primary intestinal lymphangiectasia successfully treated with octreotide. J Gastroenterol. Feb 2001;36(2):129-32. [Medline].

  16. MacLean JE, Cohen E, Weinstein M. Primary intestinal and thoracic lymphangiectasia: a response to antiplasmin therapy. Pediatrics. Jun 2002;109(6):1177-80. [Medline]. [Full Text].

  17. Maconi G, Molteni P, Manzionna G, Parente F, Bianchi Porro G. Ultrasonographic features of long-standing primary intestinal lymphangiectasia. Eur J Ultrasound. Aug 1998;7(3):195-8. [Medline].

  18. Medical Economics Staff. Physicians' Desk Reference. 56th ed. Montvale, NJ: Medical Economics Co; 2001.

  19. Ralph PM, Troutman KC. The oral manifestations of intestinal lymphangiectasia: case report. Pediatr Dent. Nov-Dec 1996;18(7):461-4. [Medline].

  20. Rust C, Pratschke E, Hartl W, Kessler M, Weibecke B, Sauerbruch T. Fibrotic entrapment of the small bowel in congenital intestinal lymphangiectasia. Am J Gastroenterol. Oct 1998;93(10):1980-3. [Medline].

  21. Salomons HA, Kramer P, Nikulasson S, Schroy PC. Endoscopic features of long-standing primary intestinal lymphangiectasia. Gastrointest Endosc. May 1995;41(5):516-8. [Medline].

  22. Sethuraman G, Malhotra AK, Khaitan BK, Sharma VK, Kumar R, Makharia GK, et al. Familial pachydermoperiostosis in association with protein-losing enteropathy. Clin Exp Dermatol. Jul 2006;31(4):531-4. [Medline].

  23. Sleisenger MV. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, and Management. 6th ed. Philadelphia: WB Saunders Co; 1998:369-75.

  24. Takahashi H, Imai K. What are the objectives of treatment for intestinal lymphangiectasia?. J Gastroenterol. Feb 2001;36(2):137-8. [Medline].

  25. Yamada T, Alpers DH, Laine L, et al. Textbook of Gastroenterology: Self-Assessment Review. Philadelphia: Lippincott Williams & Wilkins; 1999.

  26. Yang DM, Jung DH. Localized intestinal lymphangiectasia: CT findings. AJR Am J Roentgenol. Jan 2003;180(1):213-4. [Medline].

 
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