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Chronic ulcerative colitis, colonic adenocarcinoma and hypoglycemia

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This report documents the association of metastatic colonic adenocarcinoma and hypoglycemia occurring in a 40-year-old female with long-standing ulcerative colitis. Although there was extensive replacement of liver parenchyma by metastases, minimal impairment of liver-cell function and the sequence of clinical events indicated that the hypoglycemia was primarily due to the widespread neoplasm and not to hepatic insufficiency. Tumor analysis by the radioimmunoassay method failed to identify the presence of insulin. To our knowledge, this is the first report of the association of chronic ulcerative colitis, colonic adenocarcinoma and hypoglycemia.

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  1. 1.

    Ginsberg DM: Hypoglycemia associated with extrapancreatic neoplasm. Advances Intern Med 12:33, 1964

  2. 2.

    Lowbeer L: Hypoglycemia-producing extrapancreatic neoplasms. Amer J Clin Path 35:233, 1961

  3. 3.

    Nissan S, Bar-Maor A, Shafrir F: Hypoglycemia associated with extrapancreatic tumors. New Eng J Med 278:177, 1968

  4. 4.

    Bower BF, Gordan GS: Hormonal effects of non-endocrine tumors. Ann Rev Med 16:83, 1965

  5. 5.

    Yalow RS, Berson SA: Immunoassay of endogenous plasma insulin in man. J Clin Invest 39:1157, 1960

  6. 6.

    Seltzer HS, Allen EW, Herron AL Jr, et al: Insulin secretion in response to glycemic stimulus: relation of delayed initial release to carbohydrate intolerance in mild diabetes mellitus. J Clin Invest 46:323, 1967

  7. 7.

    Gonzalez FM, Gold GL, Shnider BJ: Gastrointestinal carcinoma and concomitant hypoglycemia. Ann Intern Med 58:149, 1963

  8. 8.

    Marks V, Samols E: Hypoglycemia of nonendocrine origin. Proc Royal Soc Med 59:338, 1966

  9. 9.

    Lipsett MB, Odell WD, Rosenberg LE, et al: Humoral syndromes associated with non-endocrine tumors. Ann Intern Med 61:733, 1964

  10. 10.

    Tranquada RE, Bender AB, Biegelman PM: Hypoglycemia associated with carcinoma of the cecum and syndrome of testicular feminization. New Eng J Med 266:1302, 1962

  11. 11.

    Floyd JC, Power L, Rull J, et al: Insulin and ILA in tissue extracts and plasma of patients with non-pancreatic tumors associated with hypoglycemia. Clin Res 11:297, 1962

  12. 12.

    Thompson CM, Hilferty DJ: Primary carcinoma of the liver (cholangioma) with hypoglycemic convulsions. Gastroenterology 20:158, 1952

  13. 13.

    McIntosh E: Acute phosphorus poisoning. Amer J Dis Child 34:595, 1927

  14. 14.

    Cross JB, Blackford LM: Fatal hepatogenic hypoglycemia following neoarsphenamine. JAMA 94:1739, 1930

  15. 15.

    Marks V, Rose FC: Hepatogenous hypoglycemia, Hypoglycemia. Oxford, Blackwell Scientific Publishers, 1965, p 167

  16. 16.

    Conn JW, Seltzer HS: Spontaneous hypoglycemia. Amer J Med 19:460, 1955

  17. 17.

    Unger RH: Treatment of hypoglycemia associated with pancreatic and extra-pancreatic tumors. Mod Treatm 3:386, 1966

  18. 18.

    Unger RH: The riddle of tumor hypoglycemia. Amer J Med 40:325, 1966

  19. 19.

    McFadzean AJS, Young RTT: Hypoglycemia in primary carcinoma of liver. Arch Intern Med 98:720, 1956

  20. 20.

    Klein H, Klein SP: Spontaneous hypoglycemia associated with massive hepatoma. Arch Intern Med 103:272, 1959

  21. 21.

    Landau BR, Wills N, Craig JW, et al: The mechanism of hepatoma-induced hypoglycemia. Cancer 15:1188, 1962

  22. 22.

    McFadzean AJS, Young RTT: Further observations on hypoglycemia in hepatocellular carcinoma. Amer J Med 47:220, 1969

  23. 23.

    Oleesky J, Bailey I, Samols E, et al: A fibrosarcoma with hypoglycemia and a high serum insulin level. Lancet 2:378, 1962

  24. 24.

    Boshell BR, Kirschenfeld JJ, Soteres PS: Extrapancreatic insulin-secreting tumor. New Eng J Med 270:338, 1964

  25. 25.

    Field JB, Keen H, Johnson P, et al: Insulin-like activity of non-pancreatic tumors associated with hypoglycemia. J Clin Endocr 23:1229, 1963

  26. 26.

    Porter MR, Frantz VK: Tumors associated with hypoglycemia—pancreatic and extra-pancreatic. Amer J Med 21:944, 1956

  27. 27.

    Stauffer JM, Granville GE, Law SW: Recurrent hypoglycemia and retroperitoneal fibrosarcoma. New Eng J Med 265:979, 1961

  28. 28.

    Murphy R: Hypoglycemia associated with an extrapancreatic neoplasm. Med Clin N Amer 47:391, 1963

  29. 29.

    McPeak CJ, Papaioannou AN: Nonpancreatic tumors associated with hypoglycemia. Arch Surg 93:1019, 1966

  30. 30.

    Hunt PS: Adult hypoglycemia associated with neoplasia. A report of three cases with a note on the use of diazoxide. Aust New Zeal J Surg 35:295, 1966

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Author information

Correspondence to R. Whang MD, FACP.

Additional information

The authors wish to thank Dr. D. H. Law for his helpful comments and criticism and Mrs. Mildred Hale for her secretarial assistance.

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Whang, R., Boyden, G.M., Herring, E.B. et al. Chronic ulcerative colitis, colonic adenocarcinoma and hypoglycemia. Digest Dis Sci 16, 45–50 (1971).

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  • Public Health
  • Adenocarcinoma
  • Ulcerative Colitis
  • Clinical Event
  • Hypoglycemia