Pancreatic polypeptidoma
GI NETs secreting pancreatic polypeptide have been described in humans.30 Although not yet associated with a distinct clinical syndrome, watery diarrhea, diabetes mellitus, weight loss, decreased gastric acid secretion, peptic ulceration, flushing, rashes, and acute psychosis have been described in human patients with a pancreatic polypeptidoma.30
Only one dog with a suspected pancreatic polypeptidoma has been reported in the veterinary literature.33 This dog presented for chronic vomiting, anorexia, weight loss, and lethargy.
A concurrent insulinoma was diagnosed on the basis of hypoglycemia in the face of a high serum insulin concentration. Baseline serum gastrin concentration was seven-times the upper limit of the reference range, but did not rise after secretin or calcium challenge. Serum pancreatic polypeptide concentration was 3,500-times the upper limit of the reference range. Multiple pancreatic tumors removed at exploratory laparotomy showed a strongly positive immunoreactivity for pancreatic polypeptide and a positive reaction for insulin, but no reaction for gastrin or other GI regulatory peptides. It should, however, be noted that approximately 75% of NETs of the GI tract stain positive for pancreatic polypeptide, although the clinical syndrome in these patients is caused by other neuroendocrine substances.33 Thus, it remains uncertain whether there truly was a cause-effect relationship between the extremely high serum pancreatic polypeptide concentration and the clinical signs observed in this patient.9.4.6
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