The association between non-islet cell tumors and fasting hypoglycemia has been recognized since 1929. The humoral mediator of this non-islet cell tumor hypoglycemia(NICTH) is now known as IGF-II. Hypoglycemia develops commonly in the course of
hepatocellular carcinoma (HCC), mostly late in the course and usually mild to moderate in severity. Rarely, severe hypoglycemia occurs early in the course of HCC. Suggesting NICTH. We report a case of HCC in which hypoglycemia coma due to NICTH
was
the
presenting symptom.
A 52-year-old man developed mental confusion and seizures in the early morning. At emergency room, he was found to have severe hypoglycemia. Circulating levels of insulin, C-peptide, insulin like growth factor-I(IGF-I) and growth hormone were
reduced
during hypoglycemia. Diagnostic work-up revealed that he had unresectable HCC. During admission, infusion of more than 400g of dextrose per day in addition to meals was required to prevent hypoglycemia. Because the chemotherapy was refused. He
was
transferred to a local hospital to received infusions of dextrose(J Kor Soc Endocrinol 10:65~69, 1995).
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