Case report: diabetic ketoacidosis in a patient with glucagonoma.
The development of diabetic ketoacidosis is an unusual complication of a glucagon-secreting pancreatic islet cell neoplasm, with only four reported cases in the literature. In this article, the authors report on a 46-year-old woman with a glucagonoma cosecreting pancreatic polypeptide, somatostatin, and serotonin diagnosed 8 months before the onset of diabetic ketoacidosis. She was treated with hydration, insulin, and octreotide, with improvement in her clinical course and a decrease in the glucagon, pancreatic polypeptide, and chromogranin A plasma levels. With the addition of weekly 5-FU, she has maintained a partial radiographic response and has had no further episodes of diabetic ketoacidosis for a 4.5-year period. Diabetic ketoacidosis can develop in the presence of a glucagonoma, and the pathophysiology remains unknown.
Anthony
L B
LB
Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA.
Sharp
S C
SC
May
M E
ME
D016883:Diabetic Ketoacidosis / Q000209:etiology*; D005260:Female; D005440:Fluid Therapy; D005472:Fluorouracil / Q000627:therapeutic use; D005935:Glucagonoma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D010191:Pancreatic Polypeptide / Q000378:metabolism; D012701:Serotonin / Q000378:metabolism; D013004:Somatostatin / Q000378:metabolism
D007328:Insulin; D012701:Serotonin; D013004:Somatostatin; D010191:Pancreatic Polypeptide; D015282:Octreotide; D005472:Fluorouracil