A tumour that secretes glucagon-like peptide-1 and somatostatin in a patient with reactive hypoglycaemia and diabetes

Todd, JF; Stanley, S; Roufosse, Candice; Bishop, AE; Khoo, Bernard; Bloom, S.R.; Meeran, Karim

doi:10.1016/s0140-6736(03)12256-8

Cited by 47 publications

(27 citation statements)

References 5 publications

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“…However, resistant albumin-bound GLP-1, exendin-4 (a naturally occurring peptide from the lizard Heloderma) and inhibitors of the enzyme DPP-IV are all currently in development for the treatment of diabetes (see the review by Holst 2004). Although GLP-1 may be useful in type 2 diabetic patients, it has been reported to cause hypoglycaemia in non-diabetic subjects (Todd et al 2003), which could limit its usefulness as an obesity therapy.…”

Section: Proglucagon Productsmentioning

confidence: 99%

Appetite control

Wynne¹,

Stanley²,

McGowan³

et al. 2005

Journal of Endocrinology

475

403

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Our understanding of the physiological systems that regulate food intake and body weight has increased immensely over the past decade. Brain centres, including the hypothalamus, brainstem and reward centres, signal via neuropeptides which regulate energy homeostasis. Insulin and hormones synthesized by adipose tissue reflect the long-term nutritional status of the body and are able to influence these circuits. Circulating gut hormones modulate these pathways acutely and result in appetite stimulation or satiety effects. This review discusses central neuronal networks and peripheral signals which contribute energy homeostasis, and how a loss of the homeostatic process may result in obesity. It also considers future therapeutic targets for the treatment of obesity.

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Section: Proglucagon Productsmentioning

confidence: 99%

Appetite control

Wynne¹,

Stanley²,

McGowan³

et al. 2005

Journal of Endocrinology

475

403

View full text Add to dashboard Cite

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“…www.endocrinology-journals.org insulin or other peptides with insulin-like activity , Todd et al 2003 or a combination of cachexia, renal and hepatic dysfunction, and glucose consumption by the tumour (Singh et al 2006).…”

Section: J W B De Groot Et Al: Non-islet Cell Tumour-induced Hypoglymentioning

confidence: 99%

Non-islet cell tumour-induced hypoglycaemia: a review of the literature including two new cases

Groot¹,

Rikhof²,

Doorn³

et al. 2007

Endocrine Related Cancer

202

326

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This review focuses on the tumour types and symptoms associated with non-islet cell tumourinduced hypoglycaemia (NICTH) as well as the pathogenesis, diagnosis and treatment of this rare paraneoplastic phenomenon. In addition, we report two illustrative cases of patients suffering from NICTH caused by a solid fibrous tumour and a haemangiopericytoma respectively. In the first case, NICTH resolved following complete resection of the tumour, but in the second case the patient needed long-term treatment aimed at controlling hypoglycaemia because of nonresectable metastases. Many tumour types have been associated with NICTH. The crucial event in the development of NICTH seems to be overexpression of the IGF-II gene by the tumour. NICTH is characterised by recurrent fasting hypoglycaemia and is associated with the secretion of incompletely processed precursors of IGF-II ('big'-IGF-II) by the tumour. This induces dramatic secondary changes in the circulating levels of insulin, GH, IGF-I and IGF-binding proteins, resulting in an insulin-like hypoglycaemic activity of 'big'-IGF-II.

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“…Synthetic GLP-1 analogues and/or drugs that inhibit its degradation have recently been incorporated into the therapeutic algorithm of diabetes mellitus (Nauck 2004). A case of a GLP-1 and somatostatin-secreting NET has been described, presenting with reactive hypoglycaemia and hyperglycaemia subsequently cured by surgery (Todd et al 2003). A further NET of unknown primary origin was described in a patient who presented with diffuse metastases, constipation and nocturnal itching; histology revealed a well-differentiated NET (Grade1), with positive immunostaining for CgA, GLP-1, GLP-2 and polypeptide YY (PYY).…”

Section: Ectopic Gut Hormonal and Vasoactive Peptide Secretionmentioning

confidence: 99%

Paraneoplastic syndromes secondary to neuroendocrine tumours

Kaltsas

Androulakis²,

Herder³

et al. 2010

Endocrine-Related Cancer

100

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Neuroendocrine tumours may be either benign or malignant tumours, and have the ability to synthesise and secrete biologically active substances characteristic of the cell of origin that can cause distinct clinical syndromes. The term 'paraneoplastic syndromes' (PNSs) is used to denote syndromes secondary to substances secreted from tumours not related to their specific organ or tissue of origin and/or production of autoantibodies against tumour cells; such syndromes are mainly associated with hormonal and neurological symptoms. Appreciation of the presence of such syndromes is important as clinical presentation, if not identified, may delay the diagnosis of the underlying neoplasia. Conversely, early recognition can allow for more rapid diagnosis, particularly as the coexistence of a neoplasm with a clinical or biochemical marker offers an additional determinant of tumour status/progression. PNSs can complicate the patient's clinical course, response to treatment, impact prognosis and even be confused as metastatic spread. Their diagnosis involves a multidisciplinary approach, and detailed endocrinological, neurological, radiological and histological studies are required. Correct diagnosis is essential as the treatment of choice will be different for each disorder, particularly in the case of malignant tumours; it is therefore important to develop appropriate means to correctly identify and localise these tumours. Clinical awareness and the incorporation into clinical practise of 111 In-octreotide scintigraphy, chromogranin A and other evolving biochemical marker measurement techniques have substantially contributed to the identification of patients harbouring such syndromes. Diseasespecific medical therapies are mandatory in order to prevent recurrence and/or further tumour growth. Owing to their rarity, central registration of these syndromes is very helpful in order to be able to provide evidence-based diagnostic and therapeutic approaches.

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A tumour that secretes glucagon-like peptide-1 and somatostatin in a patient with reactive hypoglycaemia and diabetes

Cited by 47 publications

References 5 publications

Appetite control

Appetite control

Non-islet cell tumour-induced hypoglycaemia: a review of the literature including two new cases

Paraneoplastic syndromes secondary to neuroendocrine tumours

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