Case report: diabetic ketoacidosis in a patient with glucagonoma

Am J Med Sci. 1995 Jun;309(6):326-7. doi: 10.1097/00000441-199506000-00006.

Abstract

The development of diabetic ketoacidosis is an unusual complication of a glucagon-secreting pancreatic islet cell neoplasm, with only four reported cases in the literature. In this article, the authors report on a 46-year-old woman with a glucagonoma cosecreting pancreatic polypeptide, somatostatin, and serotonin diagnosed 8 months before the onset of diabetic ketoacidosis. She was treated with hydration, insulin, and octreotide, with improvement in her clinical course and a decrease in the glucagon, pancreatic polypeptide, and chromogranin A plasma levels. With the addition of weekly 5-FU, she has maintained a partial radiographic response and has had no further episodes of diabetic ketoacidosis for a 4.5-year period. Diabetic ketoacidosis can develop in the presence of a glucagonoma, and the pathophysiology remains unknown.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Diabetic Ketoacidosis / etiology*
  • Female
  • Fluid Therapy
  • Fluorouracil / therapeutic use
  • Glucagonoma / complications*
  • Glucagonoma / diagnosis
  • Glucagonoma / drug therapy
  • Humans
  • Insulin / therapeutic use
  • Middle Aged
  • Octreotide / therapeutic use
  • Pancreatic Neoplasms / complications*
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / drug therapy
  • Pancreatic Polypeptide / metabolism
  • Serotonin / metabolism
  • Somatostatin / metabolism

Substances

  • Insulin
  • Serotonin
  • Somatostatin
  • Pancreatic Polypeptide
  • Octreotide
  • Fluorouracil