Recombinant Human GH in Managing Refractory Hypoglycemia in a Young Patient With Embryonal Rhabdomyosarcoma.

Area of Science:

• Endocrinology
• Oncology

Background:

• Non-islet cell tumor hypoglycemia (NICTH) is a rare paraneoplastic syndrome.
• It is typically mediated by the overproduction of insulin-like growth factor 2 (IGF-2).

Observation:

• A 24-year-old male with metastatic embryonal rhabdomyosarcoma presented with severe symptomatic hypoglycemia.
• Initial management with corticosteroids and dextrose was unsuccessful.
• Laboratory findings suggested an IGF-2-mediated pathway despite a suboptimal IGF-2/IGF-1 ratio.

Findings:

• Recombinant human growth hormone (rhGH) therapy was initiated.
• Somatropin (rhGH) administration led to the resolution of hypoglycemia.
• Patients were successfully weaned off dextrose and steroid support.

Implications:

• This case demonstrates the potential utility of rhGH in managing NICTH, particularly in non-resectable malignancies.
• Individualized treatment strategies are crucial for managing complex cases of NICTH.
• Further research into rhGH for NICTH is warranted.