Filter

Refine by subject

Refine by date

—
  • Print
  • Save
  • Print

Diagnosis and Treatment > Signs and Symptoms

You are looking at 1 - 1 of 1 items for :

Clear All
Pinaki Dutta Departments of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India

Search for other papers by Pinaki Dutta in
Google Scholar
PubMed Close
,
Anuradha Aggarwal Departments of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India

Search for other papers by Anuradha Aggarwal in
Google Scholar
PubMed Close
,
Yashpal Gogate Departments of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India

Search for other papers by Yashpal Gogate in
Google Scholar
PubMed Close
,
Uma Nahar Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India

Search for other papers by Uma Nahar in
Google Scholar
PubMed Close
,
Viral N Shah Departments of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India

Search for other papers by Viral N Shah in
Google Scholar
PubMed Close
,
Mandeep Singla Departments of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India

Search for other papers by Mandeep Singla in
Google Scholar
PubMed Close
,
N Khandelwal Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India

Search for other papers by N Khandelwal in
Google Scholar
PubMed Close
, and
Anil Bhansali Departments of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India

Search for other papers by Anil Bhansali in
Google Scholar
PubMed Close

Summary

We describe the clinical presentation, diagnostic and management issues in five cases of non-islet cell tumor hypoglycemia (NICTH), diagnosed at a tertiary care institute over a period of 15 years. The clinical, laboratory, and histopathological findings of these patients along with diagnostic utility of IGF2:IGF1 ratio are discussed. The mean age of presentation was 52 years, with a male predominance (3:2). Three patients presented with recurrent episodes of fasting hypoglycemia and it was detected in other two patients during hospitalization. Two patients had acromegaloid features that regressed following treatment. One patient had hypokalemia. Low levels of insulin, C-peptide, GH, and IGF1 were invariably found in all. The IGF2 level was elevated in only one patient; however, IGF2:IGF1 ratio was more than 10 in four of the five patients. The mean tumor size was 16.4 cm and mean weight was 3.6 kg. Four patients had mesenchymal tumors and one had epithelial tumor. NICTH is a rare cause of hypoglycemia. Hypoinsulinemic hypoglycemia with low IGF1 and IGF2:IGF1 ratio more than 10 is suggestive of this entity.

Learning points

  • NICTH should be considered in patients presenting with tumor of mesenchymal origin and hypoglycemia.

  • Hypoinsulinemic hypoglycemia with low IGF1 is a strong biochemical evidence of NICTH.

  • IGF2:IGF1 ratio of more than 10 is a complementary investigation in the absence of an assay facility for IGF2.

Taxonomy:
Clinical Overview, Gland/Organ, Hypothalamus, Pancreas, Pituitary, Topic, Endocrine-related cancer, Hormone, IGF1, IGF2, Condition/ Syndrome, Acromegaly, Hypoglycaemia, Paraneoplastic syndromes, Patient Demographics, Age, Adult, Gender, Female, Male, Ethnicity, Asian - Indian, Country of Treatment, India, Diagnosis and Treatment, Signs and Symptoms, Coma, Confusion, Investigation, CT scan, IGF1, IGF2, Insulin, PET scan, Intervention, Chemotherapy, Radiotherapy, Medication, Glucocorticoids, Prednisolone, Publication Details, Case Report Type, Unique/unexpected symptoms or presentations of a disease
DOI:
https://doi.org/10.1530/EDM-13-0046
Volume/Issue:
Volume 2013: Issue 1
Open access