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3.
Clin Med Res ; 8(3-4): 159-62, 2010 Dec.
Article in English | MEDLINE | ID: mdl-20852090

ABSTRACT

A man, aged 65 years, presented with frequent episodes of hypoglycemia and unconsciousness. Hypoglycemia was accompanied by undetectable serum insulin and C-peptide levels and a high serum insulin-like growth factor (IGF)-II level. He was found to have a retroperitoneal solitary fibrous tumor. He underwent successful resection of the tumor and had no hypoglycemic episodes after the operation. Immunohistochemical analysis revealed positive immunostaining for IGF-II in tumor cells. The presence of the high-molecular-weight form of IGF-II in the patient's serum was confirmed by immunoblotting, which suggests that his hypoglycemia was due to an increase in the plasma level of IGF-II secreted by the tumor.


Subject(s)
Hypoglycemia , Insulin-Like Growth Factor II/metabolism , Neoplasm Proteins/blood , Retroperitoneal Neoplasms , Aged , C-Peptide/blood , Humans , Hypoglycemia/blood , Hypoglycemia/diagnostic imaging , Hypoglycemia/surgery , Insulin/blood , Male , Radiography , Retroperitoneal Neoplasms/blood , Retroperitoneal Neoplasms/diagnostic imaging , Retroperitoneal Neoplasms/surgery , Unconsciousness/blood , Unconsciousness/diagnostic imaging , Unconsciousness/surgery
4.
BMJ Case Rep ; 20102010 Sep 19.
Article in English | MEDLINE | ID: mdl-22791498

ABSTRACT

A 51-year-old man was referred to the Department of Cardiology in our hospital due to severe congestive heart failure and ventricular arrhythmias in March 2008. He had repeated ventricular tachycardia for years and the left ventricular ejection fraction (EF) was 11% on admission. A myocardial biopsy revealed that over 50% cardiomyocytes were replaced by fibrosis. Due to the typical acromegalic features, he was referred to the endocrinology department and diagnosed as acromegaly. He was treated with octreotide for 8 months followed by trans-sphenoidal surgery. The plasma levels of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) decreased by octreotide and normalised by surgery after which the cardiac function improved drastically. The current case demonstrates that cardiac dysfunction in acromegaly could be recovered by normalisation of GH and IGF-1 even in the presence of severe fibrosis in the myocardium.


Subject(s)
Acromegaly/therapy , Adenoma/therapy , Cardiomyopathies/etiology , Growth Hormone-Secreting Pituitary Adenoma/therapy , Heart Failure/etiology , Human Growth Hormone/blood , Acromegaly/blood , Acromegaly/diagnosis , Acromegaly/etiology , Adenoma/blood , Adenoma/complications , Adenoma/diagnosis , Antineoplastic Agents, Hormonal/therapeutic use , Biomarkers/blood , Cardiomyopathies/blood , Cardiomyopathies/pathology , Chemotherapy, Adjuvant , Fibrosis , Growth Hormone-Secreting Pituitary Adenoma/blood , Growth Hormone-Secreting Pituitary Adenoma/complications , Growth Hormone-Secreting Pituitary Adenoma/diagnosis , Heart Failure/blood , Heart Failure/pathology , Humans , Male , Middle Aged , Octreotide/therapeutic use , Pituitary Gland/surgery
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