"Big IGF-II"-induced hypoglycemia secondary to gastric adenocarcinoma.
Non-islet cell tumor-related hypoglycemia is a rare phenomenon. We report the case of a 63 Year-old man admitted for hemiparesia and a capillary blood glucose of 20 mg/dL. The presence of an immature form of IGF-II that can mimic the effect of insulin, namely "big IGF-II", explained this patient's hypoglycaemia. A moderately differentiated adenocarcinoma of the cardia with metastatic extension to the stomach and the liver was demonstrated. Octreotide failed to control the hypoglycaemia, therefore prednisolone (2 mg/kg per day) and enteral feeding prevented new episodes of severe hypoglycaemia.
Morbois-Trabut
L
L
Service de médecine interne A, CHU Bretonneau, 2 boulevard Tonnelle, 37044 Tours Cedex 1, France. maillot@med.univ-tours.fr
Maillot
F
F
De Widerspach-Thor
A
A
Lamisse
F
F
Couet
C
C
D000230:Adenocarcinoma / Q000175:diagnosis*; D001786:Blood Glucose / Q000378:metabolism*; D017809:Fatal Outcome; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D007335:Insulin-Like Growth Factor II / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000175:diagnosis*
D001786:Blood Glucose; D007335:Insulin-Like Growth Factor II; D015282:Octreotide