Hyperglycaemia due to insulin resistance caused by interferon-gamma.
Marked hyperglycaemia (30.9 mmol l(-1)) during interferon-gamma (IFN-gamma) therapy for asymptomatic recurrent renal cancer as multiple lung metastases in a 52-year-old man is described. Although the involvement of IFN-gamma has been reported in the development of autoimmune diabetes, in this case, antibodies against pancreatic beta-cells including anti-islet cell antibody (ICA) and anti-glutamic acid decarboxylase (GAD) antibody were negative. Moreover, serum level of immunoreactive insulin (IRI) (11 microU ml(-1) at fasting) and urinary excretion of C-peptide (108 microg day(-1), reference range: 20-130) suggested insulin resistance, supported by results of insulin tolerance tests. With insulin therapy and cessation of IFN-gamma, fasting blood glucose concentration returned to 6.2 mmol l(-1), and insulin therapy was discontinued. The injection of IFN-gamma may cause hyperglycaemia because of insulin resistance, rather than beta-cell injury.
Shiba
T
T
Department of Internal Medicine, Mitsui Memorial Hospital, Tokyo, Japan.
Higashi
N
N
Nishimura
Y
Y
D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy / Q000473:pathology; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced*; D007333:Insulin Resistance / Q000502:physiology; D007371:Interferon-gamma / Q000009:adverse effects / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000473:pathology; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008875:Middle Aged
D000970:Antineoplastic Agents; D007371:Interferon-gamma