c-peptide and Kidney-Neoplasms

A 77-year-old-man with renal cell carcinoma who was undergoing nivolumab treatment visited our department due to hyperglycemia; his plasma glucose level was 379 mg/dL. Although his serum C-peptide immunoreactivity (CPR) level was preserved (5.92 ng/mL), we suspected an onset of fulminant type 1 diabetes mellitus (FT1DM) and immediately started insulin therapy. His CPR levels gradually decreased and were depleted within 1 week. We later discovered that the patient's casual CPR level had been abnormally high (11.78 ng/mL) 2 weeks before his admission. Hence, the possibility of FT1DM in hyperglycemic patients undergoing nivolumab treatment should not be excluded, even with a preserved CPR level.

Topics: Aged; Antibodies, Monoclonal; Antineoplastic Agents, Immunological; Blood Glucose; C-Peptide; Carcinoma, Renal Cell; Diabetes Mellitus, Type 1; Humans; Hyperglycemia; Insulin; Kidney Neoplasms; Male; Nivolumab

We describe a case of non-islet cell tumour hypoglycaemia (NICTH) associated with a renal cell carcinoma. Serum insulin-like growth factors (IGFs) (including IGF-II E peptide), IGF-binding proteins (IGFBPs), insulin and C-peptide were measured before and after surgical removal of the tumour. IGFBPs were visualized by Western ligand blotting. Preoperatively 'big' IGF-II and IGFBP-2 levels were raised. IGF-I, IGFBP-1 and IGFBP-3 were low, while insulin, C-peptide and GH were undetectable. These changes were reversed by 2 days postoperatively. Protease assays showed little IGFBP-3 protease activity preoperatively. Preoperatively, neutral chromatography demonstrated most of the immunoassayable IGFBP-3 in a high molecular weight form with a small amount of IGF-II. Most of the IGF-II and big IGF-II eluted in lower molecular weight forms. Postoperative samples showed a shift in IGF-II which became increasingly associated with IGFBP-3 in both low and high molecular weight complexes. By Northern blotting, expression of all species of IGF-II mRNA in the tumour was 10-fold greater than in normal human liver. The tumour did not express IGFBP-1 or IGFBP-2. IGFBP-3 was expressed in small amounts, while the expression of IGFBP-4 was two-fold higher than in liver. In conclusion, we have confirmed high levels of big IGF-II and IGFBP-2 in NICTH, changes which are reversed postoperatively. The IGF-II is derived from the tumour which overexpresses these genes but IGFBP-2 probably arises from extratumour upregulation.

Topics: Aged; Blotting, Northern; C-Peptide; Carcinoma, Renal Cell; Female; Follow-Up Studies; Humans; Hypoglycemia; Insulin; Insulin-Like Growth Factor Binding Protein 1; Insulin-Like Growth Factor Binding Protein 2; Insulin-Like Growth Factor Binding Protein 3; Insulin-Like Growth Factor Binding Proteins; Insulin-Like Growth Factor I; Insulin-Like Growth Factor II; Kidney Neoplasms; RNA, Messenger

Peptide hormones LH, FSH, TSH, e-peptide, prolactin, HCG, PTH, calcitonin and prostaglandin F2 alpha were evaluated in 25 patients with renal adenocancer. Prolactin elevation found in 45% was unrelated to the stage of the disease, while aberrant TSH and FSH were more sensitive in indicating distant metastasis. Prostaglandin F2 alpha, measured as a stable degradation product 13,14-DHK-PGF2 alpha, was frequently elevated and normalized following tumor nephrectomy within 12 month. Serum PTH was decreased in patients with tumor dissemination suggesting resorptive hypercalcemina, whereas none of the patient had circulating HCG levels. Therefore even patients without any paraneoplastic syndromes have a frequent change of peptide hormones directly or indirectly caused by renal cancer.

Topics: C-Peptide; Calcitonin; Chorionic Gonadotropin; Female; Follicle Stimulating Hormone; Hormones; Humans; Kidney Neoplasms; Luteinizing Hormone; Male; Nephrectomy; Parathyroid Hormone; Prolactin; Prostaglandins F; Thyrotropin

A series of 229 patients with urogenital carcinomas were investigated for aberrant peptide hormone activities. Serum TSH and prolactin were frequently measured in elevated levels and showed some relation to the stage of disease. Ectopic production of beta-HCG was not observed in any of the cases, thyroid and steroid hormones did not exceed the normal ranges.

Topics: Adenocarcinoma; Antibodies; C-Peptide; Cross Reactions; Female; Follicle Stimulating Hormone; Humans; Kidney Neoplasms; Luteinizing Hormone; Male; Peptides; Pituitary Hormones; Prolactin; Prostatic Hyperplasia; Prostatic Neoplasms; Thyrotropin; Urinary Bladder Neoplasms; Urogenital Neoplasms

Topics: C-Peptide; Follicle Stimulating Hormone; Humans; Kidney; Kidney Neoplasms; Male; Peptides; Polyamines; Prolactin; Prostate; Prostatic Hyperplasia; Putrescine; Spermidine; Spermine; Thyrotropin