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Non-diabetic hypoglycaemia secondary to non-islet cell tumour. a diagnosis that cannot be missed!: a case report

Abd Rahman, Najihah and Che' Man, Mohamad and Che Alhadi, Shahidah (2023) Non-diabetic hypoglycaemia secondary to non-islet cell tumour. a diagnosis that cannot be missed!: a case report. Medical Journal of Malaysia, 2 (3). pp. 240-242. ISSN 2948-3859

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Non-islet cell tumour hypoglycaemia (NICTH) is a paraneoplastic syndrome primarily due to excessive insulin�like growth factor-2 (IGF-2) production. It should be suspected in patients with tumours of any origin and hypoglycaemia. It is potentially misdiagnosed or underdiagnosed due to its rarity, non-classical clinical presentation and ambiguous lab picture. We present the case of a 48-year-old man with no known medical illness brought to the emergency department for altered sensorium, incoherent speech and abnormal movement of bilateral limbs. Initial assessment identified severe hypoglycaemia, and hepatomegaly was detected on physical examination. Five months before the current presentation, he had been seeking medical attention a few times in the primary health center for early morning lethargy and hunger pangs but failed to find clues to his symptoms. He was admitted for observations and further investigations. Subsequent investigations confirm a diagnosis of malignant pancreatic lesion with lymph node, liver and lung metastases. He refused the palliative chemotherapy offered and passed on 3 months later. This case highlights the importance of thorough clinical assessment in the case of non-diabetic hypoglycaemia to prevent the consequences of inappropriate patient management despite poor pancreatic cancer prognoses.

Item Type: Article (Case Report)
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): Kulliyyah of Medicine > Department of Family Medicine (Effective: 1st January 2011)
Kulliyyah of Medicine > Department of Surgery
Kulliyyah of Medicine
Date Deposited: 08 Mar 2024 12:22
Last Modified: 08 Mar 2024 12:22
URI: http://irep.iium.edu.my/id/eprint/111265

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