Extreme but asymptomatic hypergastrinemia with gastroparesis in a young woman with insulin dependent diabetes mellitus

Journal of Endocrinological Investigation
M CarantoniR Fellin

Abstract

Overt diabetic gastroparesis is a rare long-term complication of diabetes, probably resulting from autonomic neuropathy of vagus nerve. It is now clear that neural damage plays a pivotal role in the pathogenesis of the disease. Some studies showed high basal gastrin levels in patients with diabetic gastroparesis, but the clinical meaning of this observation is still unclear. We report the case of a young woman with Insulin Dependent Diabetes Mellitus (IDDM) who was referred to evaluate nausea and vomiting associated to ketoacidosis. Our hypothesis of autonomic neuropathy with gastroparesis was confirmed. We observed a progressive increase in fasting gastrin concentration (20-fold normal values) in the absence of any clinical and laboratory signs of Zollinger-Ellison (ZE) syndrome. The increasing vomiting induced a severe state of cachexia, which required total parenteral nutrition for a long period. All therapeutic approaches were unsuccessful, and the patient rapidly died, suggesting a possible link between the severity of the clinical picture and the gastrin plasma levels.

References

Jun 14, 1975·British Medical Journal·D J HoskingM Atkinson
Sep 1, 1986·Diabetic Medicine : a Journal of the British Diabetic Association·P H WinocourD C Anderson
Mar 1, 1968·Metabolism: Clinical and Experimental·B R ZitomerG P Kozak
Jul 1, 1984·Journal of Neurology, Neurosurgery, and Psychiatry·R J GuyP J Watkins
Apr 1, 1983·The Journal of Clinical Endocrinology and Metabolism·H SasakiR H Unger
Nov 1, 1993·Diabetic Medicine : a Journal of the British Diabetic Association·W RathmannF A Gries
Mar 1, 1996·Journal of Diabetes and Its Complications·P H Nilsson
Apr 1, 1958·Annals of Internal Medicine·P KASSANDER

❮ Previous
Next ❯

Related Concepts

Related Feeds

Autoimmune Diabetes & Tolerance

Patients with type I diabetes lack insulin-producing beta cells due to the loss of immunological tolerance and autoimmune disease. Discover the latest research on targeting tolerance to prevent diabetes.

Cachexia & Brown Fat

Cachexia is a condition associated with progressive weight loss due to severe illness. In cancer patients, it is proposed to occur as a result of tumor-induced energy wasting. Several proteins have been implicated in browning and depletion of white adipose tissue. Here is the latest research on cachexia and brown fat.

Cardiac Cachexia

Cardiac cachexia is a syndrome associated with the progressive loss of muscle and fat mass. It most commonly affects patients with heart failure and can significantly decrease the quality of life and survival in these patients. Here is the latest research on cardiac cachexia.