Background information - A patient who is otherwise fine (ie. no other illness s

Question

Background information - A patient who is otherwise fine (ie. no other illness symptoms) sees the doctor due to development of: weight loss, excessive urination and thirst. After testing, the patient was diagnosed with a glucagonoma- a pancreatic alpha cell tumor that is secreting high levels of glucagon in an unregulated manner

QUESTION - In a normal post-absorptive state, what are the stimuli that cause glucagon release; and what, if any, is/are the effect(s) of glucagon on the liver, adipose tissue and muscle? How does glucagon alter the levels of various molecules (ie. glucose, fatty acids, ketone bodies

Explanation / Answer

glucagonoma - it is type of tumor of the alpha cell of pancreas that leads to over secretion of glucogon.

these alpha cell tumor are associated with glucagonoma syndrome which ahve same symptoms which are present in pseudoglucagonoma syndrome in the absence of glucagon secreting tumor.

symptoms

1. over production of glucagon( peptide hormone)

2. glucagon inhances the blood glucose level by activating the process including gluconeogenesis and lipolysis, which is anabolic & catabolic process respectively.it also increases lipolysis(breakdown of fats). the net result cause hyperglucagonemia, anemia, diarrhea and weight loss.

3. necrolytic migratory erythema is main symtoms obsorb in patient having glucagonoma.it is characterised by the spread of erythematous blisters and swelling across areas subjected to greater pressure and friction, including the lower abdomen,buttock and groin.

4. diabetes mellitus results from imbalance of insulin and glucagon leads to glucagonoma.

diagnosis

1. blood serum contains 1000 pg/mL of glucagonoma ( normal is 50-200 pg/mL.)

2. even 40% of the patient have plasma glucagon levels ranging from 500-1000 pg/mL.

3, blood test also reveals abnormal low concentration of amino acids, zinc and essential fatty acids.

4,. the tumor itself may be localised by any number of radiographic modalities, including angiography,CT,MRI,PET, and endoscopic ultrasound.

treatment

1. it can be treated by administration of octreotide , a somatostatin analog, which inhibit the release of glucagon.

2. doxorubicin and streptozotocin is used sucessfully to selectively damaged alpha cell of pancreatic ilets.they do not destroy the tumor but they inhibit the progression of symptoms.

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