A case of hepatoma associated with hypoglycaemia and overproduction of IGF‐II (E‐21): beneficial effects of treatment with growth hormone and intrahepatic adriamycin

We describe a case of recurrent hypoglycaemia associated with a hepatoma. During hypoglycaemia serum insulin was undetectable. Plasma Insulin‐like growth factor II (IGF‐11) was not elevated although 71% of plasma IGF‐II was present as big IGF‐II (molecular weight 11 kDa) which probably represents a non‐glycated form of pro‐IGF‐II. The GH response to hypoglycaemia was Impaired and plasma levels of both IGF‐l and the GH‐dependent IGF binding protein (IGFBP‐3) were low.

[1]  R. Baxter,et al.  Serum "big insulin-like growth factor II" from patients with tumor hypoglycemia lacks normal E-domain O-linked glycosylation, a possible determinant of normal propeptide processing. , 1993, Proceedings of the National Academy of Sciences of the United States of America.

[2]  E. Froesch,et al.  Can "big" insulin-like growth factor II in serum of tumor patients account for the development of extrapancreatic tumor hypoglycemia? , 1992, The Journal of clinical investigation.

[3]  W. Daughaday,et al.  Measurement of derivatives of proinsulin-like growth factor-II in serum by a radioimmunoassay directed against the E-domain in normal subjects and patients with nonislet cell tumor hypoglycemia. , 1992, The Journal of clinical endocrinology and metabolism.

[4]  V. Marks,et al.  Alleviation of Non-Islet Cell Tumour Hypoglycaemia by Growth Hormone Therapy is Associated with Changes in IGF Binding Protein-3 , 1992, Annals of clinical biochemistry.

[5]  J. Holly,et al.  The insulin-like growth factors and their binding proteins in a case of non-islet-cell tumour-associated hypoglycaemia. , 1991, The Journal of endocrinology.

[6]  R. Baxter,et al.  Impaired formation of the ternary insulin-like growth factor-binding protein complex in patients with hypoglycemia due to nonislet cell tumors. , 1991, The Journal of clinical endocrinology and metabolism.

[7]  M. Kew,et al.  Hypoglycemia in hepatocellular carcinoma: failure of short-term growth hormone administration to reduce enhanced glucose requirements. , 1991, Metabolism: clinical and experimental.

[8]  V. Marks,et al.  INAPPROPRIATELY ELEVATED PLASMA INSULIN‐LIKE GROWTH FACTOR II IN RELATION TO SUPPRESSED INSULIN‐LIKE GROWTH FACTOR I IN THE DIAGNOSIS OF NON‐ISLET CELL TUMOUR HYPOGLYCAEMIA , 1990, Clinical endocrinology.

[9]  H. Zeisel,et al.  A specific radioimmunoassay for the growth hormone (GH)-dependent somatomedin-binding protein: its use for diagnosis of GH deficiency. , 1990, The Journal of clinical endocrinology and metabolism.

[10]  W. Daughaday,et al.  Significance of abnormal serum binding of insulin-like growth factor II in the development of hypoglycemia in patients with non-islet-cell tumors. , 1989, Proceedings of the National Academy of Sciences of the United States of America.

[11]  M. Binoux,et al.  Insulin-like growth factor (IGF) and IGF-binding proteins: comparison of human serum and lymph. , 1988, The Journal of clinical endocrinology and metabolism.

[12]  M. Kew,et al.  Evaluation of the synthetic somatostatin analogue SMS 201-995 in patients with hypoglycaemia associated with hepatocellular carcinoma. , 1988, British Journal of Cancer.

[13]  D. Hadden,et al.  Bromocriptine reduces growth hormone in acromegaly. , 1986, Archives of internal medicine.

[14]  T. Merimee,et al.  Insulin-like growth factors in patients with nonislet cell tumors and hypoglycemia. , 1986, Metabolism: clinical and experimental.

[15]  P. Zumstein,et al.  Amino acid sequence of a variant pro-form of insulin-like growth factor II. , 1985, Proceedings of the National Academy of Sciences of the United States of America.

[16]  E. Froesch,et al.  Is extrapancreatic tumor hypoglycemia associated with elevated levels of insulin-like growth factor II? , 1982, The Journal of clinical endocrinology and metabolism.

[17]  E. Froesch,et al.  Hypoglycemia associated with non-islet-cell tumor and insulin-like growth factors. , 1982, The New England journal of medicine.

[18]  C. Kahn,et al.  Hypoglycemia associated with non-islet-cell tumor and insulin-like growth factors. , 1981, The New England journal of medicine.

[19]  R. Rizza,et al.  Physiological concentrations of growth hormone exert insulin-like and insulin antagonistic effects on both hepatic and extrahepatic tissues in man. , 1981, The Journal of clinical endocrinology and metabolism.

[20]  W. Daughaday,et al.  Measurement of insulin-like growth factor II by a specific radioreceptor assay in serum of normal individuals, patients with abnormal growth hormone secretion, and patients with tumor-associated hypoglycemia. , 1981, The Journal of clinical endocrinology and metabolism.

[21]  C. Kahn.  The riddle of tumour hypoglycaemia revisited. , 1980, Clinics in endocrinology and metabolism.

[22]  C. Kahn,et al.  Hypoglycemia in association with extrapancreatic tumors: demonstration of elevated plasma NSILA-s by a new radioreceptor assay. , 1974, The Journal of clinical endocrinology and metabolism.

[23]  K. Yada,et al.  [Immunoassay of insulin]. , 1968, Rinsho byori. The Japanese journal of clinical pathology.

[24]  P. J. Randle,et al.  Immunoassay of insulin with insulin antibody preciptate. , 1963, Lancet.

[25]  P. J. Randle,et al.  Immunoassay of insulin with insulin-antibody precipitate. , 1963, The Biochemical journal.