Spontaneous hypoglycaemia due to a pleural fibroma: role of insulin like growth factors.

E A Masson, I A MacFarlane, D Graham, P Foy

Department of Medicine, University of Liverpool.

A 64 year old woman with a long history of "drop attacks" and dizzy spells was found to have spontaneous hypoglycaemia. A slowly enlarging pleural mass had been present for at least five years. At thoracotomy the mass (weight 1.7 kg) was excised and the hypoglycaemia ceased. Histologically the tumour was a pleural fibroma, with no features of malignancy. Endocrine tests before surgery showed a subnormal growth hormone response to spontaneous hypoglycaemia, a reduced concentration of serum insulin like growth factor I (IGF-I), and an inappropriately high concentration of serum insulin like growth factor II (IGF-II). After resection of the tumour the growth hormone response to insulin induced hypoglycaemia and the IGF-I and IGF-II concentrations were normal. These data suggest that the hypoglycaemia was due to production of IGF-II by the tumour, causing increased glucose utilisation and an impaired growth hormone counterregulatory response to hypoglycaemia.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Cardillo, G., Facciolo, F., Cavazzana, A. O., Capece, G., Gasparri, R., Martelli, M. (2000). Localized (solitary) fibrous tumors of the pleura: an analysis of 55 patients. Ann. Thorac. Surg. 70: 1808-1812 [Abstract] [Full Text]  
• Suter, M., Gebhard, S., Boumghar, M., Peloponisios, N., Genton, C.Y. (1999). Localized fibrous tumours of the pleura: 15 new cases and review of the literature. Eur. J. Cardiothorac. Surg. 14: 453-459 [Abstract] [Full Text]