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Insulinoma cell calcium-sensing receptor influences insulin secretion in a case with concurrent familial hypocalciuric hypercalcemia and malignant metastatic insulinoma.
[familial hypocalciuric hypercalcemia]
Arterial
stimulation
and
venous
sampling
(
ASVS
)
is
an
important
technique
for
localizing
insulinoma
.
The
principle
behind
ASVS
is
that
insulin
secretion
is
promoted
from
insulinoma
cells
by
the
injection
of
calcium
into
the
insulinoma
-feeding
artery
.
However
,
the
mechanism
for
ASVS-induced
insulin
secretion
remains
unclear
.
Both
insulinoma
and
familial
hypocalciuric
hypercalcemia
(
FHH
)
are
rare
diseases
.
This
study
reports
on
a
case
in
which
both
of
these
diseases
occur
concurrently
.
The
patient
with
FHH
also
suffered
from
insulinoma
.
We
reasoned
that
insulin
secretion
for
ASVS
is
dependent
on
the
calcium-sensing
receptor
(
CaSR
)
.
ASVS
was
performed
on
this
patient
.
The
expression
of
the
CaSR
protein
and
corresponding
mRNA
were
confirmed
.
No
significant
changes
in
the
plasma
levels
of
insulin
and
C-
peptide
were
observed
during
ASVS
.
The
patient
was
clinically
diagnosed
as
having
FHH
.
We
confirmed
that
a
mutation
in
the
CaSR
gene
was
present
in
the
genomic
DNA
of
this
patient
and
that
there
were
no
mutations
in
the
multiple
endocrine
neoplasia
type
1
gene
.
In
addition
,
expression
of
both
CaSR
mRNA
and
CaSR
protein
was
confirmed
in
the
insulinoma
samples
.
These
results
suggest
that
the
CaSR
gene
is
involved
in
ASVS-induced
insulin
secretion
.
Diseases
Validation
Diseases presenting
"mutation in the casr gene"
symptom
familial hypocalciuric hypercalcemia
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