Evaluation of the synthetic somatostatin analogue SMS 201-995 in patients with hypoglycaemia associated with hepatocellular carcinoma

Joffe, B. I.; Kew, Michael C.; Panz, Vanessa R.; Kalk, W. J.; Shires, R; Wing, Jeffrey; Seftel, H. C.

doi:10.1038/bjc.1988.170

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…Another study in which the GH level was corrected into the normal physiological range in patients with tumour associated hypoglycaemia showed no change in exogenous glucose requirements; however in the same subjects, raising GH to supraphysiological or 'acromegalic' levels reduced glucose requirements (Wing et al, 1991). We found no significant benefit after treatment with octreotide in agreement with a previous report (Joffe et al, 1988) so that it seems unlikely that the tumour had somatostatin receptors. The most beneficial treatment was intrahepatic adriamycin which restored normal levels of plasma E-21, IGF-I and IGFBP-3 and eliminated hypoglycaemia.…”

Section: Discussionsupporting

confidence: 91%

A case of hepatoma associated with hypoglycaemia and overproduction of IGF‐II (E‐21): beneficial effects of treatment with growth hormone and intrahepatic adriamycin

Hunter¹,

Daughaday²,

Callender

et al. 1994

Clinical Endocrinology

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We describe a case of recurrent hypoglycaemia associated with a hepatoma. During hypoglycaemia serum insulin was undetectable. Plasma insulin-like growth factor II (IGF-II) was not elevated although 71% of plasma IGF-II was present as big IGF-II (molecular weight 11 kDa) which probably represents a non-glycated form of pro-IGF-II. The GH response to hypoglycaemia was impaired and plasma levels of both IGF-I and the GH-dependent IGF binding protein (IGFBP-3) were low. A recently described unextracted assay directed against the first 21 amino acids of the E-domain (E-21) of proinsulin-like growth factor-II (pro-IGF-II) allows direct plasma estimation (plasma E-21) of larger molecular forms of IGF-II without interference from normal IGF-II and IGF binding proteins. Basal values were grossly elevated (23.7 and 23.8 nmol/l). Treatment with GH led to an increase in the mean plasma glucose across 24 hours (4.25 +/- 0.21 mol/l (mean +/- SEM) before treatment, compared with 4.86 mmol/l +/- 0.17 following GH (P < 0.01)) and a reduction in hypoglycaemic attacks. The treatment was associated with a rise in IGFBP-3 and small increases in insulin like growth factors. Subsequent treatment with the somatostatin analogue octreotide did not produce a significant change in plasma glucose levels or insulin-like growth factors. Two courses of intrahepatic adriamycin restored elevated levels of E-21 to normal. Total IGF-II remained normal and IGF-I increased. GH treatment was successfully withdrawn with no effect on plasma glucose or growth factor levels. The patient remained free from hypoglycaemia.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionsupporting

confidence: 91%