Glucagonoma syndrome

　　The disease is mostly malignant, the etiology is not yet clear, and it is speculated that it may be related to hypersecretion of insulin-like growth factor. It is characterized by recurrent necrotic and lytic migrating erythema, stomatitis, weight loss, and diabetes, and often accompanied by a syndrome of pancreatic cell tumors that secrete glucagon, with approximately 80% of the tumors being malignant, half of which may metastasize.

　　The main complications are abnormal blood glucose levels, leading to weight loss, easy infection, glycosuria, and other symptoms, causing necrotic and lytic migrating erythema of the skin, often accompanied by a syndrome of pancreatic cell tumors that secrete glucagon. More than half of the patients have mild to moderate diabetes, may have intermittent diarrhea, abdominal distension, vomiting, and melena. Patients are weak, weight loss, may also have hypokalemia, anemia, venous thrombosis, and mental disorders.

　　It is characterized by recurrent necrotic and lytic migrating erythema, stomatitis, weight loss, and diabetes, and often accompanied by a syndrome of pancreatic cell tumors that secrete glucagon, with approximately 80% of the tumors being malignant, half of which may metastasize. The skin lesions often appear several years before the tumor, mostly in middle-aged people, especially postmenopausal women. The skin lesions can be disseminated throughout the body on areas of friction and those prone to trauma, and trauma, pressure, and friction can induce and exacerbate the disease. The initial skin lesions are of unequal size, polygonal or irregularly shaped faint erythema, occasionally with papules and vesicles from millet to mung bean size, which turn dark purple-red within 1-2 days, with pale center or purpura-like, followed by superficial vesicles or pustules that are prone to break and form erosions and scabs. Desquamation leaves a faint brown to bronze discoloration, the erythema edge expands to the periphery, the clear red crustal edge presents in a ring-like or multiring-like pattern, most patients have severe glossitis,呈 scarlet, with superficial shedding and mild atrophy, resembling beef in appearance, and feeling tingling pain. More than half of the patients have mild to moderate diabetes, may have intermittent diarrhea, abdominal distension, vomiting, and melena. Patients are weak, weight loss, may also have hypokalemia, anemia, venous thrombosis, and mental disorders.

　　There is currently no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of the disease. Try to reduce infections, avoid contact with radiation and other toxic substances, especially drugs that suppress the immune function; the activity of potential viruses and the long-term use of certain physical and chemical substances (especially hormone drugs).

　　Erythrocyte sedimentation rate acceleration, anemia, hypoalbuminemia, intermittent diabetes, elevated fasting blood glucose, abnormal glucose tolerance test, and elevated blood glucagon levels greater than 5000mg/L can be diagnosed.

　　Histopathological examination: Biopsy of the edge of early damage shows characteristic lesions, with a high degree of intracellular edema in the superficial layer of the epidermal prickle cell layer, eosinophilic cytoplasm, nuclear condensation, possible necrosis and loosening, leading to fissures and blisters. Necrotic areas show neutrophils, and sometimes海绵样 abscesses can form, where there is no granular layer. The lower two-thirds of the prickle cell layer are normal, the dermal papillae are edematous, the blood vessels are dilated, and there is mild lymphocytic infiltration around the blood vessels.

　　1. 花生赤豆枣蒜汤

　　Formula: Peanut kernels with skin 90 grams, adzuki beans, red dates each 60 grams; garlic 30 grams.

　　Preparation: Boil all the ingredients together in water.

　　Usage: Take in the morning and evening.

　　2. 金针瓜络蚌肉汤

　　Formula: Clam meat 30 grams, chrysanthemum 15 grams, luffa 10 grams.

　　Preparation: Boil the above three ingredients in an appropriate amount of water, and add salt for seasoning.

　　Usage: Drink soup and eat meat, once a day, for 10 days.

　　3. Fish腥豆带汤

　　Formula: Mung beans 30 grams, kelp 20 grams, Houttuynia cordata 15 grams.

　　Preparation: Boil the above three ingredients in water, remove the Houttuynia cordata, and add an appropriate amount of sugar for seasoning.

　　Usage: Drink soup and eat beans and kelp. Once a day, for 7 days.

　　1. Treatment

　　Strive for surgical resection of the tumor. If there is no metastasis, radical cure can be achieved after surgery. If there is metastasis, chemotherapy drugs such as streptomycin and dacarbazine (nitrazepam) commonly used in chemotherapy can be used at the same time as the resection of the primary tumor. Other drugs such as corticosteroid hormones and tetracycline also have certain effects.

　　2. Prognosis

　　It often occurs with a syndrome associated with only pancreatic cells that secrete high levels of glucagon, about 80% of which are malignant, and half can metastasize.