Clinical Response to the Long Acting Somatostatin Analogue SMS 201-995 in a Child with Congenital Microvillus Atrophy

A 27 month old girl with congenital microvillus atrophy received two courses of SMS 201-995, a synthetic long acting analogue of native somatostatin, in an attempt to decrease profuse secretory diarrhoea. During the first trial at 13 months of age fluid and electrolytes administered by parenteral infusion were decreased as measured by water and faecal electrolyte losses. During the second trial of SMS 201-995 at 19 months fluid and electrolyte input were held constant for 14 days. Stool volume declined from 275 ml/kg to 161 ml/kg. Reductions in output of stool electrolytes (Na+, K+, Cl-) were accompanied by an increase in urine fluid output and increased excretion of urinary Na+. Subsequent administration of SMS 201-995 for a nine month period was not associated with adverse side effects or an impairment of growth velocity. These findings suggest that SMS 201-995 may be useful therapy in infants with high output diarrhoea as a result of congenital microvillus atrophy.