Tumour-Not So Sweet, Tumour-Induced Hypoglycemia: A Rare Case of Refractory Hypoglycemia in a Toddler

Tumour-Not So Sweet, Tumour-Induced Hypoglycemia: A Rare Case of Refractory Hypoglycemia in a Toddler

Tumour-induced hypoglycaemia is a rare complication/condition mainly seen in adults. It is caused due to increased production of insulin or insulin-like growth factor (IGF) 2 tumour cells. We present a 3-year-old paediatric patient with non-islet cell tumour induced hypoglycaemia (NICTH) secondary t...

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Autores principales: Jayati Joshipura, Vani H.N., Nabanita Kora
Formato: article
Lenguaje:EN
Publicado: Karger Publishers 2021
Materias:
hypoglycaemia
sarcoma
pediatric endocrinology
Diseases of the endocrine glands. Clinical endocrinology
RC648-665
Acceso en línea:https://doaj.org/article/955aebcb69334412ac8c14df6bfa46f4
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spelling oai:doaj.org-article:955aebcb69334412ac8c14df6bfa46f42021-12-02T12:40:24ZTumour-Not So Sweet, Tumour-Induced Hypoglycemia: A Rare Case of Refractory Hypoglycemia in a Toddler2673-17972673-173810.1159/000520177https://doaj.org/article/955aebcb69334412ac8c14df6bfa46f42021-12-01T00:00:00Zhttps://www.karger.com/Article/FullText/520177https://doaj.org/toc/2673-1797https://doaj.org/toc/2673-1738Tumour-induced hypoglycaemia is a rare complication/condition mainly seen in adults. It is caused due to increased production of insulin or insulin-like growth factor (IGF) 2 tumour cells. We present a 3-year-old paediatric patient with non-islet cell tumour induced hypoglycaemia (NICTH) secondary to rhabdomyosarcoma. She presented with abdominal mass and refractory hypoglycaemia, requiring high glucose infusion and steroids. Critical sample analysis during hypoglycaemia showed suppression of insulin, IGF-1, C-peptide, growth hormone, and ketones, with a high cortisol level. CT scan of abdomen and pelvis showed a huge retroperitoneal mass, later diagnosed as rhabdomyosarcoma. In a resource-limited setting, where IGF-2 is not possible, low serum insulin and IGF-1 levels during hypoglycaemia aids in diagnosis of NICTH. This is one of the first few reported paediatric cases with NICTH from India, and we believe that reporting this case would add more information to the existing literature. Thus, NICTH should be suspected in all malignancies presenting with intractable hypoglycaemia irrespective of their age.Jayati JoshipuraVani H.N.Nabanita KoraKarger Publishersarticlehypoglycaemiasarcomapediatric endocrinologyDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENDubai Diabetes and Endocrinology Journal, Pp 1-3 (2021)
institution DOAJ
collection DOAJ
language EN
topic hypoglycaemia
sarcoma
pediatric endocrinology
Diseases of the endocrine glands. Clinical endocrinology
RC648-665
spellingShingle hypoglycaemia
sarcoma
pediatric endocrinology
Diseases of the endocrine glands. Clinical endocrinology
RC648-665
Jayati Joshipura
Vani H.N.
Nabanita Kora
Tumour-Not So Sweet, Tumour-Induced Hypoglycemia: A Rare Case of Refractory Hypoglycemia in a Toddler
description Tumour-induced hypoglycaemia is a rare complication/condition mainly seen in adults. It is caused due to increased production of insulin or insulin-like growth factor (IGF) 2 tumour cells. We present a 3-year-old paediatric patient with non-islet cell tumour induced hypoglycaemia (NICTH) secondary to rhabdomyosarcoma. She presented with abdominal mass and refractory hypoglycaemia, requiring high glucose infusion and steroids. Critical sample analysis during hypoglycaemia showed suppression of insulin, IGF-1, C-peptide, growth hormone, and ketones, with a high cortisol level. CT scan of abdomen and pelvis showed a huge retroperitoneal mass, later diagnosed as rhabdomyosarcoma. In a resource-limited setting, where IGF-2 is not possible, low serum insulin and IGF-1 levels during hypoglycaemia aids in diagnosis of NICTH. This is one of the first few reported paediatric cases with NICTH from India, and we believe that reporting this case would add more information to the existing literature. Thus, NICTH should be suspected in all malignancies presenting with intractable hypoglycaemia irrespective of their age.
format article
author Jayati Joshipura
Vani H.N.
Nabanita Kora
author_facet Jayati Joshipura
Vani H.N.
Nabanita Kora
author_sort Jayati Joshipura
title Tumour-Not So Sweet, Tumour-Induced Hypoglycemia: A Rare Case of Refractory Hypoglycemia in a Toddler
title_short Tumour-Not So Sweet, Tumour-Induced Hypoglycemia: A Rare Case of Refractory Hypoglycemia in a Toddler
title_full Tumour-Not So Sweet, Tumour-Induced Hypoglycemia: A Rare Case of Refractory Hypoglycemia in a Toddler
title_fullStr Tumour-Not So Sweet, Tumour-Induced Hypoglycemia: A Rare Case of Refractory Hypoglycemia in a Toddler
title_full_unstemmed Tumour-Not So Sweet, Tumour-Induced Hypoglycemia: A Rare Case of Refractory Hypoglycemia in a Toddler
title_sort tumour-not so sweet, tumour-induced hypoglycemia: a rare case of refractory hypoglycemia in a toddler
publisher Karger Publishers
publishDate 2021
url https://doaj.org/article/955aebcb69334412ac8c14df6bfa46f4
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AT vanihn tumournotsosweettumourinducedhypoglycemiaararecaseofrefractoryhypoglycemiainatoddler
AT nabanitakora tumournotsosweettumourinducedhypoglycemiaararecaseofrefractoryhypoglycemiainatoddler
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