Document Detail

Cushing's syndrome and big IGF-II associated hypoglycaemia in a patient with adrenocortical carcinoma.
MedLine Citation:
PMID:  22461853     Owner:  NLM     Status:  In-Data-Review    
A 41-year-old woman had a general health examination and was diagnosed with a non-functioning adrenocortical carcinoma (ACC). Despite surgery and chemotherapy with mitotane, the ACC progressed with metastases to the lymph nodes, liver and lung. Initially, she developed adrenal insufficiency and was treated with hydrocortisone. As the ACC progressed, it produced superabundant cortisol, resulting in clinically overt Cushing's syndrome. As the liver metastases grew, the patient developed hypoglycaemia with suppression of endogenous insulin secretion. She had to be given large quantities of glucose intravenously to remain normoglycaemic. The serum insulin-like growth factor (IGF)-II/IGF-I ratio had increased to 84. We identified big IGF-II, a primary hormonal mediator of non-islet cell tumour hypoglycaemia (NICTH), in the serum and tumour using western blotting. This is the first case of ACC that showed both Cushing's syndrome and NICTH associated with big IGF-II.
Kazuhide Ishikura; Toshinari Takamura; Yumie Takeshita; Atsushi Nakagawa; Noriko Imaizumi; Hirofumi Misu; Komei Taji; Kazuo Kasahara; Yukinosuke Oshinoya; Shioto Suzuki; Akishi Ooi; Shuichi Kaneko
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Publication Detail:
Type:  Journal Article     Date:  2010-03-30
Journal Detail:
Title:  BMJ case reports     Volume:  2010     ISSN:  1757-790X     ISO Abbreviation:  BMJ Case Rep     Publication Date:  2010  
Date Detail:
Created Date:  2012-03-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101526291     Medline TA:  BMJ Case Rep     Country:  England    
Other Details:
Languages:  eng     Pagination:  -     Citation Subset:  -    
Kanazawa University Graduate School of Medical Science, Department of Disease Control and Homeostasis, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
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