Tumour-induced hypoglycaemia due to 'big' IGF-II.
A 57-year-old woman with a slowly growing intraabdominal leiomyosarcoma developed life-threatening hypoglycaemia. Plasma C-peptide levels were low (0.08 nmol L-1 and < 0.05 nmol L-1, reference interval 0.18-0.63 nmol L-1). Total IGF-II was normal (760 ng mL-1) whilst 'big' IGF-II was markedly elevated (440 ng mL-1). After surgical tumour reduction, 'big' IGF-II levels in plasma normalized (117 ng mL-1) and the patient experienced no new episodes of hypoglycaemia. Life-threatening hypoglycaemia due to tumour production of IGF-II can be ameliorated by reduction of the tumour burden and should be kept in mind even in incurable patients.
Department of Oncology, Rigshospitalet, Copenhagen, Denmark.
G
G
Strauss
L
L
Christensen
J
J
Zapf
D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology* / Q000503:physiopathology; D007335:Insulin-Like Growth Factor II / Q000502:physiology*; D007890:Leiomyosarcoma / Q000150:complications* / Q000503:physiopathology; D008875:Middle Aged; D011498:Protein Precursors / Q000502:physiology*; D012186:Retroperitoneal Neoplasms / Q000150:complications* / Q000503:physiopathology
D011498:Protein Precursors; C066038:proinsulin-like growth factor II; D007335:Insulin-Like Growth Factor II