دورية أكاديمية
Resolution of dysglycaemia after treatment of monoclonal gammopathy of endocrine significance.
| العنوان: | Resolution of dysglycaemia after treatment of monoclonal gammopathy of endocrine significance. |
|---|---|
| المؤلفون: | Grant, Bonnie, Ratnayake, Gowri, Williams, Claire L, Long, Anna, Halsall, David J, Semple, Robert K, Cavenagh, James D, Drake, William M, Church, David S |
| بيانات النشر: | Department of Clinical Biochemistry //dx.doi.org/10.1093/ejendo/lvad138 Eur J Endocrinol Oxford University Press (OUP) |
| سنة النشر: | 2023 |
| المجموعة: | Apollo - University of Cambridge Repository |
| مصطلحات موضوعية: | MGUS, hyperinsulinaemia, hypoglycaemia, insulin autoantibodies, lenalidomide, myeloma, plasma exchange, smouldering myeloma, Male, Humans, Aged, Monoclonal Gammopathy of Undetermined Significance, Paraproteinemias, Paraproteins, Endocrine System Diseases, Insulin, Hypoglycemia, Glucose, Multiple Myeloma |
| الوصف: | In very rare cases of monoclonal gammopathy, insulin-binding paraprotein can cause disabling hypoglycaemia. We report a 67-year-old man re-evaluated for hyperinsulinaemic hypoglycaemia that persisted despite distal pancreatectomy. He had no medical history of diabetes mellitus or autoimmune disease but was being monitored for an IgG kappa monoclonal gammopathy of undetermined significance. On glucose tolerance testing, hyperglycaemia occurred at 60 min (glucose 216 mg/dL) and hypoglycaemia at 300 min (52 mg/dL) concurrent with an apparent plasma insulin concentration of 52 850 pmol/L on immunoassay. Laboratory investigation revealed an IgG2 kappa with very high binding capacity but low affinity (Kd 1.43 × 10-6 mol/L) for insulin. The monoclonal gammopathy was restaged as smouldering myeloma not warranting plasma cell-directed therapy from a haematological standpoint. Plasma exchange reduced paraprotein levels and improved fasting capillary glucose concentrations. Lenalidomide was used to treat disabling hypoglycaemia, successfully depleting paraprotein and leading to resolution of symptoms. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| العلاقة: | https://www.repository.cam.ac.uk/handle/1810/362209Test |
| الإتاحة: | https://www.repository.cam.ac.uk/handle/1810/362209Test |
| حقوق: | Attribution 4.0 International ; https://creativecommons.org/licenses/by/4.0Test/ |
| رقم الانضمام: | edsbas.8428E888 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |