A Case of Non-islet Cell Tumor Hypoglycemia with Malignant Solitary Fibrous Tumor of the Pleura

瑛子, 片岡; 麻友美, 大塩; 知之, 五十嵐; 充, 元石; 聡, 澤井; 淳, 花岡

doi:10.2482/haigan.53.59

Cited by 3 publications

(1 citation statement)

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“…The levels of glucose regulatory hormones were then obtained retrospectively from the medical records of the patients. The levels of glucose-related hormones in 15 patients with IGF-II producing NICTH were also reviewed from case reports published in Japan after 2005 [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. IGF-II analysis of patients in these case reports was also performed at the authors' institutions.…”

Section: Plasma Glucose and Insulin Levelsmentioning

confidence: 99%

Levels of glucose-regulatory hormones in patients with non-islet cell tumor hypoglycemia: including a review of the literature

et al. 2017

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RECURRENT fasting hypoglycemia occurs in association with certain kinds of tumors other than insulinomas. This paraneoplastic syndrome is classified as non-islet cell tumor hypoglycemia (NICTH) and its incidence is considerably less than hypoglycemia caused by insulinomas. Following a case report of a patient with leiomyosarcoma associated with hypoglycemia who had large molecular weight (big) insulin-like growth factor (IGF)-II detected in both the tumor and the circulation, and the finding of structural and functional similarities between IGF-II and (pro) insulin, overproduction and secretion of big IGF-II Levels of glucose-regulatory hormones in patients with non-islet cell tumor hypoglycemia: including a review of the literature Izumi Fukuda 1) , Akira Asai 1) , Tomoko Nagamine 1) , Taro Harada 1) , Kyoko Tanimura-Inagaki 1) , Naomi Hizuka 2) and Hitoshi Sugihara Abstract. Non-islet cell tumor hypoglycemia (NICTH) is one of the causes of spontaneous hypoglycemia. The pathogenesis of NICTH is thought to be an excessive production by tumors of big insulin-like growth factor (IGF)-II. This study investigated the levels of glucose-regulatory hormones in patients with NICTH with high serum levels of big IGF-II (big IGF-II group) and compared these with profiles of patients with spontaneous hypoglycemia with normal IGF-II (normal IGF-II group). Circulating IRI, CPR, ACTH, cortisol, GH, and IGF-I levels measured during hypoglycemic episodes were examined retrospectively in 37 patients with big IGF-II producing NICTH and 6 hypoglycemic patients with normal IGF-II. The hormone profile data of 15 patients with NICTH from published case reports were reviewed and included in the analyses. Mean plasma glucose levels (36 vs. 29 mg/dL), serum IRI (0.53 vs. 0.37 µIU/mL), CPR (0.15 vs. 0.20 ng/mL), IGF-I SDS (-3.55 vs. -3.18 SD) and ACTH levels (27.3 vs. 33.8 pg/mL) were not significantly different between the big and normal IGF-II groups. However, mean serum GH (0.85 vs. 9.62 ng/mL) and plasma cortisol levels (16.2 vs. 34.5 μg/dL) were significantly lower in the big IGF-II group than in the normal IGF-II group (both p<0.05). In conclusion, although the magnitude of the decrease in insulin and IGF-I levels did not differ between spontaneous hypoglycemic patients caused by other etiologies, patients with NICTH tended to have low basal GH levels during hypoglycemic episodes. These differences in hormone profile may be helpful for selecting patients who require analysis of IGF-II.

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