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Ovarian germinoma accelerating the presentation of diabetes mellitus
Yvonne Yijuan Lim1, Kah-Yin Loke, Cindy Weili Ho
1Divisions of *Paediatric Endocrinology and Diabetes ‡Paediatric Haematology and Oncology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System †Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Abstract:
A 12-year-old girl presented to the Children's Emergency Department with symptoms of diabetes mellitus. Glutamic acid decarboxylase autoantibodies and anti-Islet cell antibodies were absent. She was also found to have ovarian dysgerminoma with markedly elevated serum β-human chorionic gonadotropin (β-HCG). With treatment of her ovarian tumor and normalization of the serum β-HCG her insulin therapy was quickly discontinued and metformin started. The ovarian dysgerminoma appeared to have accelerated the presentation of severe diabetes. We hypothesized that the elevated β-HCG and possibly other placental hormones from the germ cell tumor caused her to develop insulin resistance and inadequate β-cell insulin secretory response.
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