PT  - JOURNAL ARTICLE
AU  - E A Masson
AU  - I A MacFarlane
AU  - D Graham
AU  - P Foy
TI  - Spontaneous hypoglycaemia due to a pleural fibroma: role of insulin like growth factors.
AID  - 10.1136/thx.46.12.930
DP  - 1991 Dec 01
TA  - Thorax
PG  - 930--931
VI  - 46
IP  - 12
4099  - http://thorax.bmj.com/content/46/12/930.short
4100  - http://thorax.bmj.com/content/46/12/930.full
SO  - Thorax1991 Dec 01; 46
AB  - 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.