[Hypoglycemia associated with pleural fibromas. Study of insulin-like growth factors (IGF) and pathogenic considerations].
OBJECTIVE
Pathogeny of hypoglycemia associated with non-islet-cell tumors is unclear. We discuss the mechanisms of this syndrome.


BACKGROUND
We report three cases of spontaneous hypoglycemia revealing pleural fibroma. Endocrine tests before surgery showed low serum growth hormone and insulin-like growth factor I (IGF-I), reduced serum IGF-II levels in two patient. Insulin-like growth factor binding protein-3 (IGFBP-3) was low and electrophoretic profile of IGF-II was the 'big IGF-II' type. We discuss the mechanisms of hypoglycemia associated with non-islet-cell tumor. Impaired formation of the ternary complexes and its consequences seem the main pathogenic factor.


CONCLUSIONS
Analysis of IGF and IGFBP and in situ measurements of IGF mRNA could help in understanding this syndrome and allow therapeutic considerations in the management of hypoglycemia by corticosteroids and growth hormone.
Hamidou
M
M
Service de médecine interne A, Hôtel-Dieu, CHU, 44035 Nantes, France. mohamed.hamidou@chu-nantes.fr
Bani-Sadr
F
F
Kenzi
A
A
Sagan
C
C
Grolleau
J Y
JY
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D005350:Fibroma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology*; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D007335:Insulin-Like Growth Factor II / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed
D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I; D007335:Insulin-Like Growth Factor II
Hypoglycémie associée aux fibromes pleuraux. Etude des insulin-like growth factors (IGF) et considérations pathogéniques.