Tryptophan metabolites in hypoglycemia associated with neoplasia

• Published in: Cancer Vol. 19; no. 12; pp. 2024 - 2028
• Main Authors: Silverstein, Murray N., Wakim, Khalil G., Bahn, Robert C.
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 01.12.1966
• Subjects: Adenoma, Islet Cell - complications; Adrenal Gland Neoplasms - complications; Adult; Breast Neoplasms - complications; Female; Humans; Hypoglycemia - complications; Male; Middle Aged; Neoplasm Metastasis - complications; Tryptophan - blood; Tryptophan - urine
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(196612)19:12<2024::AID-CNCR2820191229>3.0.CO;2-S

Studies on tryptophan metabolites in the blood and urine of 5 additional patients having symptoms of hypoglycemia associated with neoplasia are reported. Three patients having islet cell tumors and hypoglycemia had normal levels of tryptophan metabolites in the blood and urine during hypoglycemia. A patient with metastatic carcinoma of the breast and a patient with metastatic adrenal carcinoma also had normal values for tryptophan metabolites in the blood and urine during hypoglycemia. These patients are compared with 2 previously reported patients who had extrapancreatic neoplasms, hypoglycemia and high levels of tryptophan metabolites in the blood and urine. The findings suggest that, when a patient has high levels of tryptophan metabolites in the blood and urine during hypoglycemia, a diligent search for extrapancreatic neoplasm should be undertaken. When tryptophan metabolites in the blood and urine are normal during hypoglycemia, a careful search for an islet cell neoplasm is indicated.