title: [Hepatocellular carcinoma complicated by non-islet cell tumor hypoglycemia].
abstract: A 36-year-old woman presented with right upper quadrant abdominal pain, weight loss and attacks of severe sweating. She was known to have a chronic hepatitis B infection. A large hepatocellular carcinoma was diagnosed complicated by recurrent episodes of hypoglycaemia. Serum insulin, insulin-like growth factor (IGF-I) and growth hormone levels proved to be low, with increased serum levels of big-IGF-II. This is indicative of non-islet cell tumour hypoglycaemia. The patient received prednisone which resulted in an improvement in the blood glucose values but the morning hypoglycaemia remained, so that nightly intravenous glucose administration continued to be necessary. Therefore, growth hormone was added to the treatment which resulted in a complete disappearance of the hypoglycaemias. The patient died within 6 months of the diagnosis having been established.
authors.affiliation: Academisch Ziekenhuis Rotterdam-Dijkzigt, Postbus 2040, 3000 CA Rotterdam.
authors.forename: P
authors.initials: P
authors.lastname: van Wijngaarden
authors.forename: J A M J L
authors.initials: JA
authors.lastname: Janssen
authors.forename: R A
authors.initials: RA
authors.lastname: de Man
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000150:complications*; D017809:Fatal Outcome; D005260:Female; D019382:Human Growth Hormone / Q000097:blood / Q000627:therapeutic use; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000188:drug therapy / Q000209:etiology*; D007328:Insulin / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007335:Insulin-Like Growth Factor II / Q000378:metabolism; D008113:Liver Neoplasms / Q000097:blood / Q000150:complications*; D012008:Recurrence
chemical_list: D007328:Insulin; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D007335:Insulin-Like Growth Factor II