Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2015 May 6:2015:bcr2014209021.
doi: 10.1136/bcr-2014-209021.

A mitotic cause of Whipple's triad: non-islet cell tumour hypoglycaemia in incurable low-grade malignancy

Angela S Lee  1 , Stephen M Twigg  1
Affiliations
Case Reports

A mitotic cause of Whipple's triad: non-islet cell tumour hypoglycaemia in incurable low-grade malignancy

Angela S Lee et al. BMJ Case Rep. .

Abstract

A 74-year-old man with known metastatic haemangiopericytoma presented with neuroglycopaenic symptoms of confusion and light-headedness secondary to recurrent episodes of fasting hypoglycaemia, which resolved with oral carbohydrate intake. Investigations for hypoglycaemia revealed it to be non-insulin mediated, and subsequently due to a rare paraneoplastic phenomenon termed as non-islet cell tumour hypoglycaemia caused by tumoural overproduction of high molecular weight insulin-like growth factor-II. Despite his underlying malignancy being incurable, directed multimodality treatment involving regular oral carbohydrate intake, glucocorticoid therapy and recombinant human growth hormone was effective in relieving symptoms of hypoglycaemia. We discuss the importance of a systematic diagnostic approach to hypoglycaemia fulfilling Whipple's triad, as specific therapies can be invaluable to improving quality of life.

PubMed Disclaimer

Figures

Figure 1
Figure 1
CT scan with intravenous contrast (coronal view) showing multiple lung and liver metastatic deposits of haemangiopericytoma.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Cryer PE, Axelrod L, Grossman AB et al. . Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2009;94:709–28. 10.1210/jc.2008-1410 - DOI - PubMed
    1. de Groot JW, Rikhof B, van Doorn J et al. . Non-islet cell tumour-induced hypoglycaemia: a review of the literature including two new cases. Endocr Relat Cancer 2007;14:979–93. 10.1677/ERC-07-0161 - DOI - PubMed
    1. Dynkevich Y, Rother KI, Whitford I et al. . Tumors, IGF-2, and hypoglycemia: insights from the clinic, the laboratory, and the historical archive. Endocr Rev 2013;34:798–826. 10.1210/er.2012-1033 - DOI - PubMed
    1. Baxter RC. The role of insulin-like growth factors and their binding proteins in tumor hypoglycemia. Horm Res 1996;46:195–201. 10.1159/000185023 - DOI - PubMed
    1. Bodnar TW, Acevedo MJ, Pietropaolo M. Management of non-islet-cell tumor hypoglycemia: a clinical review. J Clin Endocrinol Metab 2014;99:713–22. 10.1210/jc.2013-3525 - DOI - PMC - PubMed

Publication types

MeSH terms