Reproduction of features of the glucagonoma syndrome with continuous intravenous glucagon infusion as therapy for tumor-induced hypoglycemia.
OBJECTIVE
To describe the adverse effects of continuous intravenous infusion of glucagon as therapy for tumor-induced hypoglycemia and to correlate these treatment-related effects with symptoms of endogenous hyper-glucagonemia.


METHODS
We reviewed three cases in which patients received continuous glucagon therapy for tumor-induced hypoglycemia and experienced adverse side effects to the treatment. We noted that these adverse events were consistent with changes that are described in the literature as symptoms of the glucagonoma syndrome.


RESULTS
Continuous intravenous glucagon infusion has evolved as a reliable and efficacious modality for the treatment of tumor-induced hypoglycemia. We report the adverse events of venous thromboembolism, necrolytic migratory erythema, and angular cheilitis in conjunction with continuous intravenous glucagon treatment. These complications resemble symptoms that characterize the human model of hyperglucagonemia--the glucagonoma syndrome--which is associated with hyperglucagonemia and alpha-islet cell neoplasms of the pancreas.


CONCLUSIONS
Symptoms that characterize the islet cell neoplasm-related glucagonoma syndrome may develop in patients receiving an infusion of exogenous glucagon. This observation lends support to the suggestion that glucagon may have a direct, causative role.
Case
Christopher C
CC
Division of Endocrinology and Metabolism, Baylor College of Medicine, Houston, Texas, USA.
Vassilopoulou-Sellin
Rena
R
D003875:Drug Eruptions / Q000473:pathology; D005260:Female; D005934:Glucagon / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005935:Glucagonoma / Q000378:metabolism*; D006391:Hemangioma / Q000150:complications; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy* / Q000209:etiology*; D007262:Infusions, Intravenous; D007340:Insulinoma / Q000150:complications / Q000378:metabolism*; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000378:metabolism*; D010997:Pleural Neoplasms / Q000150:complications; D012509:Sarcoma / Q000150:complications
D005934:Glucagon