Dose-related effects of growth hormone on IGF-I and IGF-binding protein-3 levels in non-islet cell tumour hypoglycaemia

• Published in: European journal of endocrinology Vol. 139; no. 5; pp. 532 - 536
• Main Authors: Drake, WM, Miraki, F, Siddiqi, A, Yateman, M, Barnes, NC, Camacho-Hubner, C, Monson, JP
• Format: Journal Article
• Language: English
• Published: Colchester European Society of Endocrinology 01.11.1998; Portland Press
• Subjects: Aged; Biological and medical sciences; Case Reports; Chromatography, Gel; Dose-Response Relationship, Drug; Fibrosarcoma - blood; Fibrosarcoma - diagnostic imaging; Hormones. Endocrine system; Human Growth Hormone - adverse effects; Human Growth Hormone - therapeutic use; Humans; Hypoglycemia - drug therapy; Insulin-Like Growth Factor Binding Protein 3 - blood; Insulin-Like Growth Factor I - metabolism; Insulin-Like Growth Factor II - metabolism; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Pleural Neoplasms - blood; Pleural Neoplasms - diagnostic imaging; Radionuclide Imaging; Tomography, X-Ray Computed; United Kingdom; Europe; Human; Replacement therapy; Treatment efficiency; Somatotropin hormone; Male; Malignant tumor; Insulin like growth factor 1; Hypoglycemia; Blood plasma; Insulin like growth factor binding protein; Protein hormone; Chemotherapy; Adenohypophyseal hormone; Pleural disease; Adult; Paraneoplastic syndrome; Effective dose; Recombinant protein; Pleura
• ISSN: 0804-4643; 1479-683X
• DOI: 10.1530/eje.0.1390532

Mesenchymal tumours are a well recognised cause of spontaneous hypoglycaemia. The mechanism is thought to relate to hypersecretion by tumour cells of high molecular mass insulin-like growth factor-II (pro-IGF-II), with consequent suppression of growth hormone (GH) secretion. The use of recombinant human (rh)GH has been reported to alleviate hypoglycaemia in non-islet cell tumour hypoglycaemia, and the mechanism is thought to relate to GH-mediated increments in serum levels of IGF-binding protein-3 (IGFBP-3), thereby reducing the bioavailability of IGF-II. We report the effect of increasing doses of rhGH on the clinical condition and serum IGF-I and IGFBP-3 levels in two patients with solitary pleural fibrous tumours causing severe hypoglycaemia. Hypoglycaemia was successfully alleviated in each patient although, despite using large doses of rhGH, the observed increments in IGFBP-3 were only modest. We postulate that the beneficial effects of rhGH in this situation are likely to be multifactorial and not simply related to increments in serum IGFBP-3 levels.