Hypoglycaemia in non-beta-cells tumours
Authors:
Peter Galajda; Marián Mokáň
Authors‘ workplace:
I. interná klinika Jesseniovej LF UK a UNM, Martin
Published in:
Forum Diab 2014; 3(1): 28-33
Category:
Main Theme: Review
Overview
Non-beta-cells tumours are rare cause of hypoglycaemia. There are usually characterized such mesenchymal or epithelial tumours with huge size, slow growth and increased production of insulin like growth factor IGF2 (IGF2-oma). In non-beta-cells tumours there is present fasting hypoglycaemia associated with increased levels of total and free IGF2 as well as big IGF2 form. Due to suppression effect there are decreased levels of insulin, growth hormone and IGF1 and ratio IGF2/IGF1 is typically increased. Hypoglycaemia is caused by increased IGF2 levels and in the case of very huge tumours also by increased glucose utilization in tumour tissue. Attacks of hypoglycaemia may be diminished after successful treatment of primary non-beta-cells tumour.
Key words:
hypoglycaemia – IGF2 – insulin like growth factor 2 – non-beta-cells tumours
Sources
1. Mokáň M. Hypoglykémia. Vydavateľstvo P+M: Turany-Martin, 2005. ISBN: 8096874268.
2. Mokáň M, Galajda P. Hypoglykémia pri vybraných vnútorných chorobách. Quick Print: Martin 2011. ISBN 978–80–970660–6–2.
3. Samoš M, Kalinová S, Galajda P et al. Hypoglykémia u hospitalizovaných pacientov bez diabetes mellitus. Diabetes a obezita 2012; 12(23): 53–58.
4. Ságová I, Klimentová A, Prídavková D et al. Paraneoplastická hyperglykémia – popis prípadu a prehľad problematiky. Vnitr Lek 2013; 59(5): 402–406.
5. Daughaday WH. Hypoglycemia due to paraneoplastic secretion of insulin-like growth factor-I. J Clin Endocrinol Metab 2007; 92(5): 1616.
6. Dynkevich Y, Rother KI, WHitford I, et al. Tumors, IGF-2 and hypoglycemia: Insight from clinic, the laboratory and the historical archive. Endocrin Rew 2013; 34(6):798–826.
7. Livingstone C. IGF2 and cancer. Endocrine Related Cancer 2013; 20(6): R321–39. Dostupné z DOI: <http://doi: 10.1530/ERC-13–0231>.
8. Hiramatsu K, Takahashi K, Kanemoto N et al. A case of pheochromocytoma with transient hyperinsulinemia and reactive hypoglycemia. Jpn J Med 1987; 26(1): 88–90.
9. Furrer J, Hättenschwiler A, Komminotch P et al. Carcinoid syndrome, acromegaly, and hypoglycemia due to an insulin-secreting neuroendocrine tumor of the liver. J Clin Endocrinol Metab 2001; 86(5): 2227–2230.
10. Morken NH, Majak B, Kahn JA. Insulin producing primary ovarian carcinoid tumor. Acta Obstet Gynecol Scand 2007; 86(4): 500–501.
11. Hinchliffe E, Allcock RL, Mansoor W et al. A patient with a metastatic gastroenteropancreatic endocrine carcinoma causing hyperinsulinaemic hypoglycaemia and the carcinoid syndrome. Ann Clin Biochem 2011; 48(6): 579–583.
12. Eastman RC, Carson RE, Orloff D et al. Glucose utilization in a patient with hepatoma and hypoglycaemia. J Clin Invest 1992; 89(6): 1958–1963.
13. Habra MA, Núñez R, Chuang H et al. Fatal hypoglycemia in malignant pheochromocytoma: direct glucose consumption as suggested by (18)F-2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography imaging. Endocrine. 2010; 37(1): 209–212.
14. Braund WJ, Naylor BA, Williamson DH et al. Autoimmunity to insulin receptor and hypoglycaemia in patients with Hodgkin´s disease. Lancet 1987; 237(8527): 237–240.
15. Arnqvist HJ, Halban PA, Mathiesen UL et al. Hypoglycaemia caused by atypical insulin antibodies in a patient with benign monoclonal gammapathy. J Intern Med 1993; 234(4): 421–427.
16. Flier JS, Usher P, Moller DE et al. Induction of the glucose transport system by tumor necrosis factor/cachectin: Implications for the hypoglycemia of sepsis and tumors. Clin Res 1987; 35: A512.
17. Mahony SM, Tisdale MJ. Metabolic effects of tumour necrosis factor alpha in NMRI mice. Br J Cancer 1990; 61(4): 514–519.
18. De Groot JWB, Rikhof B, Doorn J et al. Non-islet cell tumour-induced hypoglycaemia: a review of the literature including two new cases. Endocrine-Related Cancer 2007; 14(4): 979–993.
19. Fukuda I, Hizuka N, Ishikawa Y et al. Clinical features of insulin-like growth factor-II producing non-islet-cell tumor hypoglycemia. Growth Horm IGF Res 2006; 16(4): 211–216.
20. Perros P, Simpson J, Innes JA et al. Non-islet cell tumour-associated hypoglycaemia: 111inoctreotide imaging and efficacy of octreotide, growth hormone and glucocorticosteroids. Clin Endocrinol (Oxf). 1996; 44(6): 727–731.
21. Gullo D, Sciacca L, Parrinello G et al. Treatment of hemangiopericytoma-induced hypoglycemia with growth hormone and corticosteroids. J Clin Endocrinol Metab 1999; 84(5): 1758–1759.
22. Silveira LFG, Bouloux PMG, MacColl GS et al. Growth hormone therapy for non-islet cell tumor hypoglycemia. Am J Med 2002; 113(3): 255–257.
23. Verweij J, Casali PG, Zalcberg J et al. Progression free survival in gastrointestinal stromal tumours with high-dose imatinib: randomised trial. Lancet 2004; 364(0440): 1127–1134.
24. Leong S, Gore I, Benjamin R et al. A phase I study of R1507, a human monoclonal antibody IGF-1R antagonist given weekly in patients with advanced solid tumor. AACR-NCI-EORTC International Conference on Molecular Targets and Cancer Therapeutics 2007; A78.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Forum Diabetologicum
![Issue 1](https://www.forumdiabetologicum.sk/media/cache/resolve/journal_issue/media/image_pdf/1261352e2e219d5e3c6427eeb4a2080e.jpeg)
2014 Issue 1
Most read in this issue
- Acute complications of diabetes mellitus – incidence in patients in intensive care units and case report
- Hypoglycaemia in non-beta-cells tumours
- Hypoglycaemia as cardiovascular risk factor
-
Treatment of type 2 diabetes: How low do you go?
Treat early, treat safely!