Glucagonoma with necrolytic migratory erythema exhibiting responsiveness to subcutaneous octreotide injections

摘要

A 51-year-old woman with a half-year history of diabetes meilitus presented to our gastrointestinal clinic with an ulcerating rash, primarily on her shins, thighs, groin and abdomen (Figure 1a); cheilitis and glossitis. Her symptoms had been worsening for 10 months despite specialized wound care. In addition, she noted concurrent weight loss from 57 to 47 kg in 10 months, abdominal pain, abdominal fullness and poor appetite. Physical examination disclosed an eczematous skin lesion over her body including her extremities, mild anemic conjunctivae, an ovoid and tense abdomen, shifting dullness, and grade 2 pitting edema over the bilateral lower legs. Laboratory tests revealed nor-mocytic anemia (hemoglobin 10.2 g/dl), hypoalbu-minemia (albumin 2.6 g/dl) and elevated hemoglobin HbAic (HbA1c 8.6). Her international normalized ratio coagulation test findings, white blood cell count and liver and pancreatic enzyme values were within normal ranges.