Schweichler M, Hennessey J V, Cole P, Perdue J F, Le Roith D
Division of Endocrinology, Brown University, Providence, Rhode Island, USA.
Obstet Gynecol. 1995 May;85(5 Pt 2):810-3. doi: 10.1016/0029-7844(94)00313-3.
In nondiabetic women, pregnancy alone rarely causes clinical hypoglycemia. Non-islet cell tumors have recently been shown to be associated with the production of insulin-like growth factor II (IGF-II) and a paraneoplastic syndrome resulting in hypoglycemia. A case report and review of pathophysiologic mechanisms involved is presented.
A 38-year-old multigravida presented suffering from clinical and biochemical hypoglycemia, which was found to be secondary to a mesothelioma of the pleura and ectopic IGF-II production. Tumor resection was performed during the 13th gestational week. The mother became euglycemic immediately after the surgery and remained asymptomatic. Clinical indicators of pregnancy and an ultrasound scan after the surgery were consistent with a normal viable fetus.
Symptomatic hypoglycemia and other medical conditions occurring during pregnancy require immediate diagnosis and treatment. In addition to the more common causes, documented cases of medical conditions due to paraneoplastic syndromes of ectopic hormone production during pregnancy have been described. This case establishes the non-islet cell tumor with IGF-II-induced hypoglycemia as another such syndrome to be considered when evaluating hypoglycemia in pregnancy.
在非糖尿病女性中，单纯妊娠很少导致临床低血糖。最近发现非胰岛细胞瘤与胰岛素样生长因子II（IGF-II）的产生以及导致低血糖的副肿瘤综合征有关。本文报告了一例病例，并对所涉及的病理生理机制进行了综述。
一名38岁经产妇出现临床和生化低血糖，发现是由胸膜间皮瘤和异位IGF-II产生所致。在妊娠第13周进行了肿瘤切除术。术后母亲立即血糖恢复正常，且无症状。术后妊娠的临床指标和超声检查结果与正常存活胎儿一致。
孕期出现的症状性低血糖和其他病症需要立即诊断和治疗。除了更常见的原因外，已有文献记载孕期因异位激素产生的副肿瘤综合征导致病症的病例。该病例确定了IGF-II诱导低血糖的非胰岛细胞瘤是孕期评估低血糖时另一种需要考虑的此类综合征。
