Medicine in images
Doege-Potter syndrome: What hypoglycemia hid
Síndrome de Doege-Potter: lo que la hipoglucemia escondía
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Santos-Seoane, R. Fernández-Madera-Martínez, H. Canto-Argiz" "autores" => array:3 [ 0 => array:4 [ "nombre" => "S.M." "apellidos" => "Santos-Seoane" "email" => array:1 [ 0 => "smsspulp@yahoo.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "R." "apellidos" => "Fernández-Madera-Martínez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "H." "apellidos" => "Canto-Argiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital de Cabueñes, Gijón, Asturias, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Neumología, Hospital de Cabueñes, Gijón, Asturias, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Síndrome de Doege-Potter: lo que la hipoglucemia escondía" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 502 "Ancho" => 1750 "Tamanyo" => 102831 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 69-year-old woman underwent laboratory tests for asthenia, which measured a blood glucose level of 17. The patient complained of moderate effort dyspnea and dry cough. Chest radiography revealed submassive left pleural effusion, for which thoracentesis was performed, obtaining a hematological exudate with a glucose level higher than in serum. Computed tomography showed a considerable solid and heterogeneous mass measuring 14.6<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>15.4<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>20<span class="elsevierStyleHsp" style=""></span>cm, with calcification. There were also areas with increased uptake, necrotic areas and cystic degeneration areas, which affected the parietal pleura in its middle and lower parts, without infiltrating the chest wall. This mass caused considerable mediastinal and cardiac displacement and presented significant vascularization with numerous vascular branches dependent on both the descending and abdominal aortas (<a class="elsevierStyleCrossRef" href="#fig0005">Figs. 1A–C</a>). We ruled out hyperinsulinism, and the insulin-like growth factor-I and II measurements were normal. From the morphological and immunohistochemical standpoint, the biopsy was compatible with a solitary fibrous pleural tumor.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Solitary fibrous tumors represent 8% of benign chest malignancies and 10% of pleural tumors. The tumors originate in serous membranes, dura mater and deep soft tissues. Thirty percent of these tumors occur in the chest cavity and usually have a benign course and a casual diagnosis. The tumors can cause coughing, dyspnea, chest pain, pleural effusion, joint pain, acropachy and hypoglycemia.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Refractory hypoglycemia (Doege-Potter syndrome) occurs in less than 5% of cases, mainly in peritoneal/giant pleural tumors. The condition is characteristically hypoinsulinemic and caused by the tumor secretion of a “big” growth factor similar to type 2 insulin (big-IGF2), which acts by displacing the IGF of transport proteins. Tumor extirpation typically eliminates the symptoms.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-05-23" "fechaAceptado" => "2018-06-17" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Santos-Seoane SM, Fernández-Madera-Martínez R, Canto-Argiz H. Síndrome de Doege-Potter: lo que la hipoglucemia escondía. Rev Clín Esp. 2019;219:346–347.</p>" ] ] "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 502 "Ancho" => 1750 "Tamanyo" => 102831 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000021900000006/v1_201907300655/S2254887418301474/v1_201907300655/en/main.assets" "Apartado" => array:4 [ "identificador" => "71811" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Medicine in images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000021900000006/v1_201907300655/S2254887418301474/v1_201907300655/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887418301474?idApp=WRCEE" ]
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