title: A common problem in the elderly with an uncommon cause: hypoglycaemia secondary to the Doege-Potter syndrome.
abstract: Falls due to hypoglycaemia in the elderly is usually a complication of diabetic treatment. In the absence of diabetes, hypoglycaemia may be due to insulin or insulin-like producing tumours. The Doege-Potter syndrome is a rare paraneoplastic syndrome, characterised by non-islet cell tumour hypoglycaemia (NICTH) secondary to a solitary fibrous tumour that secretes insulin-like growth factor (IGF) 2. Definitive treatment of hypoglycaemia due to NICTH is by tumour resection. Our patient was a 78-year-old woman admitted after a fall with a facial injury and a history of significant weight loss. Her blood sugar was persistently low despite intravenous dextrose infusion. CT of the thorax revealed a large heterogeneous mass measuring 11.6×16.3×15.6 cm in the right hemithorax. A biopsy of the mass was reported as a solitary fibrous tumour. Biochemical investigations revealed low insulin, C-peptide, IGF-1 and a high IGF-2:IGF-1 ratio, consistent with NICTH. The patient underwent tumour resection and the hypoglycaemia normalised completely immediately after surgery.
authors: National University of Singapore, Singapore.
authors: Cheong Kiat Julian
authors: CK
authors: Tay
authors: Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore.
authors: Hui Lin
authors: HL
authors: Teoh
authors: Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore.
authors: Su
authors: S
authors: Su
mesh_terms: D000368:Aged; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D010257:Paraneoplastic Syndromes / Q000150:complications* / Q000175:diagnosis; D010994:Pleura / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010997:Pleural Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D054364:Solitary Fibrous Tumors / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed
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