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The effectiveness of different treatment options for non-islet cell tumour hypoglycaemia
Summary objective To compare the outcome of different treatment options used in several cases of non‐islet cell tumour hypoglycaemia (NICTH). patients Eight cases of NICTH were referred for diagnosis and monitoring following either surgical or medical treatment. methods Serum samples collected th...
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Published in: | Clinical endocrinology (Oxford) 2004-04, Vol.60 (4), p.457-460 |
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container_title | Clinical endocrinology (Oxford) |
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creator | Teale, J. D. Wark, G. |
description | Summary
objective To compare the outcome of different treatment options used in several cases of non‐islet cell tumour hypoglycaemia (NICTH).
patients Eight cases of NICTH were referred for diagnosis and monitoring following either surgical or medical treatment.
methods Serum samples collected throughout the time‐course of each case were analysed for glucose, insulin, C‐peptide, IGF‐I, total IGF‐II, total IGF‐II to IGF‐I ratio and, in most of the cases, big IGF‐II.
results Surgical excision was successful in the relief of symptoms and normalization of the biochemical parameters. Therapeutic treatment with glucocorticoids confirmed previous studies showing the suppressive effect on tumour (big) IGF‐II production. The present data show that the effect was dose‐dependent and reversible if doses were below a critical level.
conclusions Within the limits of the cases studied, and the time‐scales involved, moderate‐ to high‐dose glucocorticoid therapy had immediate beneficial influence on symptomatic hypoglycaemia and, if tolerated in the long term, was effective in correcting the underlying biochemical dysfunction, unlike other therapeutic regimens. This effectiveness was only achieved when the dose exceeded a threshold level specific to the patient. In addition, reduction of the dose or withdrawal of the drug caused a return of the abnormal biochemical profile. Surgical removal of the malignancy, where this was an option, was successful within the periods studied. |
doi_str_mv | 10.1111/j.1365-2265.2004.01989.x |
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objective To compare the outcome of different treatment options used in several cases of non‐islet cell tumour hypoglycaemia (NICTH).
patients Eight cases of NICTH were referred for diagnosis and monitoring following either surgical or medical treatment.
methods Serum samples collected throughout the time‐course of each case were analysed for glucose, insulin, C‐peptide, IGF‐I, total IGF‐II, total IGF‐II to IGF‐I ratio and, in most of the cases, big IGF‐II.
results Surgical excision was successful in the relief of symptoms and normalization of the biochemical parameters. Therapeutic treatment with glucocorticoids confirmed previous studies showing the suppressive effect on tumour (big) IGF‐II production. The present data show that the effect was dose‐dependent and reversible if doses were below a critical level.
conclusions Within the limits of the cases studied, and the time‐scales involved, moderate‐ to high‐dose glucocorticoid therapy had immediate beneficial influence on symptomatic hypoglycaemia and, if tolerated in the long term, was effective in correcting the underlying biochemical dysfunction, unlike other therapeutic regimens. This effectiveness was only achieved when the dose exceeded a threshold level specific to the patient. In addition, reduction of the dose or withdrawal of the drug caused a return of the abnormal biochemical profile. Surgical removal of the malignancy, where this was an option, was successful within the periods studied.</description><identifier>ISSN: 0300-0664</identifier><identifier>EISSN: 1365-2265</identifier><identifier>DOI: 10.1111/j.1365-2265.2004.01989.x</identifier><identifier>PMID: 15049960</identifier><identifier>CODEN: CLECAP</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Blood Glucose - analysis ; C-Peptide - blood ; Endocrinopathies ; Female ; Fundamental and applied biological sciences. Psychology ; Glucocorticoids - administration & dosage ; Glucocorticoids - therapeutic use ; Human Growth Hormone - therapeutic use ; Humans ; Hypoglycemia - blood ; Hypoglycemia - drug therapy ; Hypoglycemia - etiology ; Insulin - blood ; Insulin-Like Growth Factor I - analysis ; Insulin-Like Growth Factor II - analysis ; Male ; Medical sciences ; Middle Aged ; Neoplasms - complications ; Neoplasms - drug therapy ; Neoplasms - surgery ; Prednisolone - administration & dosage ; Prednisolone - therapeutic use ; Protein Precursors - analysis ; Vertebrates: endocrinology</subject><ispartof>Clinical endocrinology (Oxford), 2004-04, Vol.60 (4), p.457-460</ispartof><rights>2004 INIST-CNRS</rights><rights>Copyright Blackwell Scientific Publications Ltd. Apr 2004</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4609-6bfba5d36a71877b9417cbfdf671f3fcacafe68823fbb91d6d95fbd49c50241b3</citedby><cites>FETCH-LOGICAL-c4609-6bfba5d36a71877b9417cbfdf671f3fcacafe68823fbb91d6d95fbd49c50241b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15647311$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15049960$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Teale, J. D.</creatorcontrib><creatorcontrib>Wark, G.</creatorcontrib><title>The effectiveness of different treatment options for non-islet cell tumour hypoglycaemia</title><title>Clinical endocrinology (Oxford)</title><addtitle>Clin Endocrinol (Oxf)</addtitle><description>Summary
objective To compare the outcome of different treatment options used in several cases of non‐islet cell tumour hypoglycaemia (NICTH).
patients Eight cases of NICTH were referred for diagnosis and monitoring following either surgical or medical treatment.
methods Serum samples collected throughout the time‐course of each case were analysed for glucose, insulin, C‐peptide, IGF‐I, total IGF‐II, total IGF‐II to IGF‐I ratio and, in most of the cases, big IGF‐II.
results Surgical excision was successful in the relief of symptoms and normalization of the biochemical parameters. Therapeutic treatment with glucocorticoids confirmed previous studies showing the suppressive effect on tumour (big) IGF‐II production. The present data show that the effect was dose‐dependent and reversible if doses were below a critical level.
conclusions Within the limits of the cases studied, and the time‐scales involved, moderate‐ to high‐dose glucocorticoid therapy had immediate beneficial influence on symptomatic hypoglycaemia and, if tolerated in the long term, was effective in correcting the underlying biochemical dysfunction, unlike other therapeutic regimens. This effectiveness was only achieved when the dose exceeded a threshold level specific to the patient. In addition, reduction of the dose or withdrawal of the drug caused a return of the abnormal biochemical profile. Surgical removal of the malignancy, where this was an option, was successful within the periods studied.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Blood Glucose - analysis</subject><subject>C-Peptide - blood</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Glucocorticoids - administration & dosage</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Human Growth Hormone - therapeutic use</subject><subject>Humans</subject><subject>Hypoglycemia - blood</subject><subject>Hypoglycemia - drug therapy</subject><subject>Hypoglycemia - etiology</subject><subject>Insulin - blood</subject><subject>Insulin-Like Growth Factor I - analysis</subject><subject>Insulin-Like Growth Factor II - analysis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasms - complications</subject><subject>Neoplasms - drug therapy</subject><subject>Neoplasms - surgery</subject><subject>Prednisolone - administration & dosage</subject><subject>Prednisolone - therapeutic use</subject><subject>Protein Precursors - analysis</subject><subject>Vertebrates: endocrinology</subject><issn>0300-0664</issn><issn>1365-2265</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><recordid>eNqNkEFv0zAYhi0EYmXwF5CFBLdkn-PEjg8cUFkH2lSENMRuluPYzCWJOzuB9t_j0GpMO-GLP9nP--nVgxAmkJN0zjY5oazKioJVeQFQ5kBELfLdE7S4_3iKFkABMmCsPEEvYtwAQFUDf45OSAWlEAwW6Ob61mBjrdGj-2UGEyP2FrcuvQQzjHgMRo39PPnt6PwQsfUBD37IXOzMiLXpOjxOvZ8Cvt1v_Y9ur5XpnXqJnlnVRfPqeJ-ib6vz6-Wn7OrLxeflh6tMlwxExhrbqKqlTHFSc96IknDd2NYyTiy1WmllDavrgtqmEaRlrahs05ZCV1CUpKGn6N1h7zb4u8nEUfYuzq3UYPwUJSec1xSKBL55BG5S6SF1k0ker4GyMkH1AdLBxxiMldvgehX2koCc1cuNnA3L2bCc1cu_6uUuRV8f909Nb9p_waPrBLw9Aipq1dmgBu3iA46VnBKSuPcH7rfrzP6_C8jl-XqeUj475F0cze4-r8JPyTjllfy-vpBfPxK2Wt1cyjX9A6A1r58</recordid><startdate>200404</startdate><enddate>200404</enddate><creator>Teale, J. D.</creator><creator>Wark, G.</creator><general>Blackwell Science Ltd</general><general>Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>200404</creationdate><title>The effectiveness of different treatment options for non-islet cell tumour hypoglycaemia</title><author>Teale, J. D. ; Wark, G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4609-6bfba5d36a71877b9417cbfdf671f3fcacafe68823fbb91d6d95fbd49c50241b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Blood Glucose - analysis</topic><topic>C-Peptide - blood</topic><topic>Endocrinopathies</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Glucocorticoids - administration & dosage</topic><topic>Glucocorticoids - therapeutic use</topic><topic>Human Growth Hormone - therapeutic use</topic><topic>Humans</topic><topic>Hypoglycemia - blood</topic><topic>Hypoglycemia - drug therapy</topic><topic>Hypoglycemia - etiology</topic><topic>Insulin - blood</topic><topic>Insulin-Like Growth Factor I - analysis</topic><topic>Insulin-Like Growth Factor II - analysis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasms - complications</topic><topic>Neoplasms - drug therapy</topic><topic>Neoplasms - surgery</topic><topic>Prednisolone - administration & dosage</topic><topic>Prednisolone - therapeutic use</topic><topic>Protein Precursors - analysis</topic><topic>Vertebrates: endocrinology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Teale, J. D.</creatorcontrib><creatorcontrib>Wark, G.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical endocrinology (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Teale, J. D.</au><au>Wark, G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effectiveness of different treatment options for non-islet cell tumour hypoglycaemia</atitle><jtitle>Clinical endocrinology (Oxford)</jtitle><addtitle>Clin Endocrinol (Oxf)</addtitle><date>2004-04</date><risdate>2004</risdate><volume>60</volume><issue>4</issue><spage>457</spage><epage>460</epage><pages>457-460</pages><issn>0300-0664</issn><eissn>1365-2265</eissn><coden>CLECAP</coden><abstract>Summary
objective To compare the outcome of different treatment options used in several cases of non‐islet cell tumour hypoglycaemia (NICTH).
patients Eight cases of NICTH were referred for diagnosis and monitoring following either surgical or medical treatment.
methods Serum samples collected throughout the time‐course of each case were analysed for glucose, insulin, C‐peptide, IGF‐I, total IGF‐II, total IGF‐II to IGF‐I ratio and, in most of the cases, big IGF‐II.
results Surgical excision was successful in the relief of symptoms and normalization of the biochemical parameters. Therapeutic treatment with glucocorticoids confirmed previous studies showing the suppressive effect on tumour (big) IGF‐II production. The present data show that the effect was dose‐dependent and reversible if doses were below a critical level.
conclusions Within the limits of the cases studied, and the time‐scales involved, moderate‐ to high‐dose glucocorticoid therapy had immediate beneficial influence on symptomatic hypoglycaemia and, if tolerated in the long term, was effective in correcting the underlying biochemical dysfunction, unlike other therapeutic regimens. This effectiveness was only achieved when the dose exceeded a threshold level specific to the patient. In addition, reduction of the dose or withdrawal of the drug caused a return of the abnormal biochemical profile. Surgical removal of the malignancy, where this was an option, was successful within the periods studied.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>15049960</pmid><doi>10.1111/j.1365-2265.2004.01989.x</doi><tpages>4</tpages></addata></record> |
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subjects | Adult Aged Aged, 80 and over Biological and medical sciences Blood Glucose - analysis C-Peptide - blood Endocrinopathies Female Fundamental and applied biological sciences. Psychology Glucocorticoids - administration & dosage Glucocorticoids - therapeutic use Human Growth Hormone - therapeutic use Humans Hypoglycemia - blood Hypoglycemia - drug therapy Hypoglycemia - etiology Insulin - blood Insulin-Like Growth Factor I - analysis Insulin-Like Growth Factor II - analysis Male Medical sciences Middle Aged Neoplasms - complications Neoplasms - drug therapy Neoplasms - surgery Prednisolone - administration & dosage Prednisolone - therapeutic use Protein Precursors - analysis Vertebrates: endocrinology |
title | The effectiveness of different treatment options for non-islet cell tumour hypoglycaemia |
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