title: "Big IGF-II"-induced hypoglycemia secondary to gastric adenocarcinoma.
abstract: 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.
authors.affiliation: Service de médecine interne A, CHU Bretonneau, 2 boulevard Tonnelle, 37044 Tours Cedex 1, France. maillot@med.univ-tours.fr
authors.forename: L
authors.initials: L
authors.lastname: Morbois-Trabut
authors.forename: F
authors.initials: F
authors.lastname: Maillot
authors.forename: A
authors.initials: A
authors.lastname: De Widerspach-Thor
authors.forename: F
authors.initials: F
authors.lastname: Lamisse
authors.forename: C
authors.initials: C
authors.lastname: Couet
mesh_terms: 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*
chemical_list: D001786:Blood Glucose; D007335:Insulin-Like Growth Factor II; D015282:Octreotide