PMID- 31263567
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220409
IS  - 2055-1169 (Electronic)
IS  - 2055-1169 (Linking)
VI  - 5
IP  - 1
DP  - 2019 Jan-Jun
TI  - Non-islet-cell tumour hypoglycaemia in a cat with hepatocellular carcinoma.
PG  - 2055116919856129
LID - 10.1177/2055116919856129 [doi]
LID - 2055116919856129
AB  - CASE SUMMARY: An 11-year-old male neutered domestic shorthair cat presented with 
      behavioural changes. Physical examination revealed bradycardia and a cranial 
      abdominal mass. The cat was persistently hypoglycaemic (1.2 mmol/l; reference 
      interval [RI] 3.5-5.5 mmol/l) with decreased fructosamine concentration 
      suggesting chronic hypoglycaemia, and decreased insulin concentration excluding 
      insulinoma. Alanine aminotransferase activity was markedly increased (1219.31 
      U/l; RI 15-60 U/l). On staging CT a large, multilobulated hepatic mass was 
      identified, with no evidence of metastatic disease. After surgical removal serum 
      glucose concentration and heart rate quickly returned to within the RIs. 
      Histopathology was consistent with a solid-to-trabecular, well-differentiated, 
      hepatocellular carcinoma. There was no recurrence of signs or mass during 8 
      months of follow-up, and the cat was still alive 20 months after surgery. 
      RELEVANCE AND NOVEL INFORMATION: Non-islet-cell tumour hypoglycaemia (NICTH) is a 
      rare but life-threatening paraneoplastic syndrome. In humans, hepatocellular 
      carcinoma is the most common epithelial tumour causing NICTH, but these are 
      uncommon in cats, and associated paraneoplastic hypoglycaemia has not been 
      reported. Possible mechanisms include aberrant secretion of big insulin growth 
      factor 2; however, this could not be confirmed. NICTH should be considered in the 
      differential diagnosis of cats with persistent hypoglycaemia.
FAU - Guillen, Alexandra
AU  - Guillen A
AD  - Department of Small Animal Clinical Science, Institute of Veterinary Science, 
      University of Liverpool, Neston, UK.
FAU - Ressel, Lorenzo
AU  - Ressel L
AD  - Department of Veterinary Pathology and Public Health, Institute of Veterinary 
      Sciences, University of Liverpool, Neston, UK.
FAU - Finotello, Riccardo
AU  - Finotello R
AD  - Department of Small Animal Clinical Science, Institute of Veterinary Science, 
      University of Liverpool, Neston, UK.
FAU - German, Alexander J
AU  - German AJ
AD  - Department of Small Animal Clinical Science, Institute of Veterinary Science, 
      University of Liverpool, Neston, UK.
FAU - Freeman, Alistair
AU  - Freeman A
AD  - Department of Small Animal Clinical Science, Institute of Veterinary Science, 
      University of Liverpool, Neston, UK.
FAU - Blackwood, Laura
AU  - Blackwood L
AD  - Department of Small Animal Clinical Science, Institute of Veterinary Science, 
      University of Liverpool, Neston, UK.
LA  - eng
PT  - Case Reports
DEP - 20190626
PL  - England
TA  - JFMS Open Rep
JT  - JFMS open reports
JID - 101672978
PMC - PMC6595665
OTO - NOTNLM
OT  - HCC
OT  - IGF-2
OT  - hepatocellular carcinoma
OT  - hypoglycaemia
OT  - insulin growth factor 2
OT  - paraneoplastic
COIS- Conflict of interest: AJG is an employee of the University of Liverpool, but his 
      post is financially supported by Royal Canin. AJG has also received financial 
      remuneration for providing educational material, speaking at conferences and 
      consultancy work from this company; all such remuneration has been for projects 
      unrelated to the work reported in this manuscript.
EDAT- 2019/07/03 06:00
MHDA- 2019/07/03 06:01
PMCR- 2019/06/26
CRDT- 2019/07/03 06:00
PHST- 2019/07/03 06:00 [entrez]
PHST- 2019/07/03 06:00 [pubmed]
PHST- 2019/07/03 06:01 [medline]
PHST- 2019/06/26 00:00 [pmc-release]
AID - 10.1177_2055116919856129 [pii]
AID - 10.1177/2055116919856129 [doi]
PST - epublish
SO  - JFMS Open Rep. 2019 Jun 26;5(1):2055116919856129. doi: 10.1177/2055116919856129. 
      eCollection 2019 Jan-Jun.