title: Hypoglicemia related to big Haemangiopericitoma: a difficult diagnostic definition.
abstract: We describe the case of a 91 years old woman admitted to our department for dyspnea associated with drowsiness. At the admission to the Emergency Room the patient stay in a comatose state and blood tests performed showing severe hypoglycemia (38 mg/dl at admission in non diabetic patient). Anamnestic history: multifactorial anemia; frequent hospitalizations for heart failure; AMI treated with stenting; in 1986 Haemangiopericytoma resection in the right iliac region; in 2006 palliative surgery for recurrence with residual mass. Blood tests showed lower levels of insulin and normal C- peptide serum concentration in correspondence of low glucose concentration (in relation to continuous and adequate parenteral nutrition), IGF 1 and GH level was respectively suppressed (IGF1=47 ng/ml whit normal range 97-331 ng/ml) and normal/low (GH 0.43 uUI/mL whit normal range 0.06-14.00 uUI/mL).Therefore hypoglycemia appeared related to paraneoplastic production of IGF -2.
authors.affiliation: Parma University Hospital, Parma, Italy. csiniscalchi@gmail.com.
authors.forename: Carmine
authors.initials: C
authors.lastname: Siniscalchi
authors.forename: Manuela
authors.initials: M
authors.lastname: Basaglia
authors.forename: Davide
authors.initials: D
authors.lastname: Cunzi
authors.forename: Simona
authors.initials: S
authors.lastname: Merla
authors.forename: Maria
authors.initials: M
authors.lastname: Mattioli
authors.forename: Nicola
authors.initials: N
authors.lastname: Gaibazzi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Volpi
mesh_terms: D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006393:Hemangiopericytoma / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D007335:Insulin-Like Growth Factor II / Q000378:metabolism; D012186:Retroperitoneal Neoplasms / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed
chemical_list: C035170:IGF2 protein, human; D007335:Insulin-Like Growth Factor II