A Diabetic Patient with Glucagonoma Syndrome Diagnosed 20 years after Appearance of Nonspecific Skin Lesions and Hyperglycemia.
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A 68-year-old man was referred to our hospital with diabetes mellitus, exanthema of the legs, and weight loss. He had been diagnosed with diabetes when 46 years old and diet therapy was initiated, but glucose control was poor. He had suffered from intractable exanthema of the lower legs since age 48. Insulin therapy was started when he was 59, after which his exanthema worsened. Close examination on admission showed hypoproteinemia, marked anemia, and a calcified pancreatic tumor in computed tomography (CT) scanning. Plasma pancreatic glucagon (IRG) was 2360pg/m<I>l</I>. After subtotal pancreatectomy with total splenectomy, skin lesions and high IRG disappeared. The tumor was diagnosed immunohistopathologically as glucagonoma. Exanthema in this patient was inconsistent with necrolytic migratory erythema (NME), a pathognomonic symptom of glucagonoma syndrome.<BR>In summary, glucagonoma was found 20 years after diabetes was diagnosed, indicating the difficulty of making a differential diagnosis of skin lesions.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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