Autoimmune reactions in a patient with malignant insulinoma treated by multiple low dose streptozotocin.
A 66-year-old female patient with a malignant insulinoma was treated with streptozotocin (STZ; Zanosar) in 5 cycles every 4 weeks as 5 day courses with an intravenous dosage of 850 mg per day. Under this treatment hypoglycemic episodes decreased continuously in number as well as severity and - after a delay of 12 months after the last treatment - an overt diabetes mellitus appeared. Plasma insulin concentrations dropped immediately after starting of STZ therapy. On the other hand, islet cell surface antibodies and their complement-dependent cytotoxicity increased continuously, being at their highest 6 months after termination of STZ treatment. Thus, STZ is able to induce a specific immune response against islet cells with a progressive damage of malignant insulin producing cells.
Schulz
B
B
Central Institute of Diabetes Gerhardt Katsch, Karlsburg/GDR.
Hehmke
B
B
Zander
E
E
Ziegler
B
B
D007516:Adenoma, Islet Cell / Q000276:immunology*; D000368:Aged; D015551:Autoimmunity / Q000187:drug effects*; D001786:Blood Glucose; D003602:Cytotoxicity, Immunologic / Q000187:drug effects; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007340:Insulinoma / Q000188:drug therapy / Q000276:immunology*; D007515:Islets of Langerhans / Q000276:immunology; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000276:immunology*; D013311:Streptozocin / Q000627:therapeutic use*
D001786:Blood Glucose; D007328:Insulin; D013311:Streptozocin