Clinical features of insulin-like growth factor-II producing non-islet-cell tumor hypoglycemia.

In some patients with non-islet-cell tumor hypoglycemia (NICTH), a high molecular weight form of IGF-II (big IGF-II) derived from tumors is present in the circulation and might be associated with recurrent hypoglycemia. In this study, in order to survey the clinical characteristics of patients with IGF-II producing NICTH, we analyzed the medical records of 78 patients with NICTH (M/F 44/34, age 62+/-1.8, range; 9-86 years.) whose serum contained a large amount of big IGF-II. Hepatocellular carcinoma and gastric carcinoma were the most common causes of NICTH. The diameters of the tumors were more than 10 cm in 70% of the patients. Basal immunoreactive insulin (IRI) levels were less than 3 microU/dl in 79% of the patients. Hypoglycemic attack was the onset of disease in 31 of 65 cases (48%), but the tumor was revealed prior to the occurrence of hypoglycemia in 34 cases (52%). Twenty-five of 47 (53%) patients had decreased serum potassium levels. These data suggested that hypoinsulinemic hypoglycemia associated with the presence of a large tumor supports the diagnosis of IGF-II producing NICTH. Hypokalemia was associated with hypoglycemia in some patients. The BMI (21.4+/-0.6 kg/m2) and serum total protein levels (6.6+/-0.1g/dl) were preserved at the occurrence of first hypoglycemic attack suggesting that malnutrition might not be the main cause of hypoglycemia in most patients.
AuthorsIzumi Fukuda, Naomi Hizuka, Yukiko Ishikawa, Kumiko Yasumoto, Yuko Murakami, Akira Sata, Junko Morita, Makiko Kurimoto, Yumiko Okubo, Kazue Takano
JournalGrowth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society (Growth Horm IGF Res) Vol. 16 Issue 4 Pg. 211-6 (Aug 2006) ISSN: 1096-6374 [Print] Scotland
PMID16860583 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
Chemical References
  • Blood Glucose
  • IGF2 protein, human
  • Proteins
  • Insulin-Like Growth Factor I
  • Insulin-Like Growth Factor II
  • Adolescent
  • Adrenal Gland Neoplasms (secretion)
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Glucose (analysis)
  • Breast Neoplasms (secretion)
  • Carcinoma, Hepatocellular (secretion)
  • Carcinoma, Renal Cell (secretion)
  • Child
  • Female
  • Fibrosarcoma (secretion)
  • Gastrointestinal Stromal Tumors (secretion)
  • Humans
  • Hypoglycemia (etiology)
  • Insulin-Like Growth Factor I (analysis)
  • Insulin-Like Growth Factor II
  • Leiomyosarcoma (secretion)
  • Liver Neoplasms (secretion)
  • Male
  • Middle Aged
  • Neoplasms (pathology, secretion)
  • Pancreatic Neoplasms (secretion)
  • Pheochromocytoma (secretion)
  • Prostatic Neoplasms (secretion)
  • Proteins (secretion)
  • Retrospective Studies
  • Stomach Neoplasms (secretion)

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