title: Ovarian germinoma accelerating the presentation of diabetes mellitus.
abstract: A 12-year-old girl presented to the Children's Emergency Department with symptoms of diabetes mellitus. Glutamic acid decarboxylase autoantibodies and anti-Islet cell antibodies were absent. She was also found to have ovarian dysgerminoma with markedly elevated serum β-human chorionic gonadotropin (β-HCG). With treatment of her ovarian tumor and normalization of the serum β-HCG her insulin therapy was quickly discontinued and metformin started. The ovarian dysgerminoma appeared to have accelerated the presentation of severe diabetes. We hypothesized that the elevated β-HCG and possibly other placental hormones from the germ cell tumor caused her to develop insulin resistance and inadequate β-cell insulin secretory response.
authors.affiliation: Divisions of *Paediatric Endocrinology and Diabetes ‡Paediatric Haematology and Oncology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System †Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Yvonne Yijuan
authors.initials: YY
authors.lastname: Lim
authors.forename: Kah-Yin
authors.initials: KY
authors.lastname: Loke
authors.forename: Cindy Weili
authors.initials: CW
authors.lastname: Ho
authors.forename: Miriam S
authors.initials: MS
authors.lastname: Kimpo
authors.forename: Yung-Seng
authors.initials: YS
authors.lastname: Lee
mesh_terms: D002648:Child; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D003920:Diabetes Mellitus / Q000209:etiology*; D005260:Female; D018237:Germinoma / Q000097:blood / Q000150:complications*; D006801:Humans; D007333:Insulin Resistance; D010051:Ovarian Neoplasms / Q000097:blood / Q000150:complications*
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human