Abs R, Verbist L, Moeremans M, Blockx P, De Leeuw I, Bekaert J
University of Antwerp, Department of Endocrinology, Belgium.
Acta Endocrinol (Copenh). 1990 Mar;122(3):319-22. doi: 10.1530/acta.0.1220319.
A selective glucagon deficiency was documented in a 36-year-old female patient suffering from severe hypoglycemic attacks. The extremely low fasting plasma glucagon levels could not be stimulated by hypoglycemia. The increase in plasma glucagon during stimulation with arginine did not prevent hypoglycemia provoked by the simultaneous insulin secretion. Treatment consisting of a continuous sc glucagon infusion system resulted in correction of both postabsorptive and postprandial hypoglycemia. Further lowering of the glucose level during an arginine test could be the hallmark of this hypoglycemic syndrome characterized by an inappropriate glucagon secretion. This case report would indicate that epinephrine cannot prevent hypoglycemia when glucagon release is completely deficient.
一名36岁患有严重低血糖发作的女性患者被证实存在选择性胰高血糖素缺乏。空腹血浆胰高血糖素水平极低，低血糖状态下无法被刺激升高。精氨酸刺激期间血浆胰高血糖素升高，但并不能预防同时分泌的胰岛素引发的低血糖。持续皮下注射胰高血糖素输注系统的治疗纠正了吸收后和餐后低血糖。精氨酸试验期间血糖水平进一步降低可能是这种以胰高血糖素分泌不当为特征的低血糖综合征的标志。该病例报告表明，当胰高血糖素释放完全缺乏时，肾上腺素无法预防低血糖。
