title: Case report: diabetic ketoacidosis in a patient with glucagonoma.
abstract: 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.
authors.affiliation: Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: L B
authors.initials: LB
authors.lastname: Anthony
authors.forename: S C
authors.initials: SC
authors.lastname: Sharp
authors.forename: M E
authors.initials: ME
authors.lastname: May
mesh_terms: 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
chemical_list: D007328:Insulin; D012701:Serotonin; D013004:Somatostatin; D010191:Pancreatic Polypeptide; D015282:Octreotide; D005472:Fluorouracil