Case Christopher C, Vassilopoulou-Sellin Rena
Division of Endocrinology and Metabolism, Baylor College of Medicine, Houston, Texas, USA.
Endocr Pract. 2003 Jan-Feb;9(1):22-5. doi: 10.4158/EP.9.1.22.
To describe the adverse effects of continuous intravenous infusion of glucagon as therapy for tumor-induced hypoglycemia and to correlate these treatment-related effects with symptoms of endogenous hyper-glucagonemia.
We reviewed three cases in which patients received continuous glucagon therapy for tumor-induced hypoglycemia and experienced adverse side effects to the treatment. We noted that these adverse events were consistent with changes that are described in the literature as symptoms of the glucagonoma syndrome.
Continuous intravenous glucagon infusion has evolved as a reliable and efficacious modality for the treatment of tumor-induced hypoglycemia. We report the adverse events of venous thromboembolism, necrolytic migratory erythema, and angular cheilitis in conjunction with continuous intravenous glucagon treatment. These complications resemble symptoms that characterize the human model of hyperglucagonemia--the glucagonoma syndrome--which is associated with hyperglucagonemia and alpha-islet cell neoplasms of the pancreas.
Symptoms that characterize the islet cell neoplasm-related glucagonoma syndrome may develop in patients receiving an infusion of exogenous glucagon. This observation lends support to the suggestion that glucagon may have a direct, causative role.
描述持续静脉输注胰高血糖素治疗肿瘤诱导的低血糖症的不良反应，并将这些与治疗相关的效应与内源性高胰高血糖素血症的症状相关联。
我们回顾了3例接受持续胰高血糖素治疗肿瘤诱导的低血糖症并出现治疗不良反应的病例。我们注意到这些不良事件与文献中描述为胰高血糖素瘤综合征症状的变化一致。
持续静脉输注胰高血糖素已发展成为治疗肿瘤诱导的低血糖症的一种可靠且有效的方法。我们报告了与持续静脉输注胰高血糖素治疗相关的静脉血栓栓塞、坏死性游走性红斑和口角炎等不良事件。这些并发症类似于高胰高血糖素血症——胰高血糖素瘤综合征的人类模型所具有的症状，该综合征与高胰高血糖素血症和胰腺α胰岛细胞瘤有关。
接受外源性胰高血糖素输注的患者可能会出现胰岛细胞瘤相关的胰高血糖素瘤综合征的特征性症状。这一观察结果支持了胰高血糖素可能具有直接因果作用的观点。
