CASE REPORT

Reversible dilated cardiomyopathy associated with glucagonoma

K Chang-Chretien¹, J T Chew², D P Judge¹

¹ Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland, USA
² Howard County General Hospital, Columbia, Maryland, USA

Correspondence to:
Correspondence to:
Dr Daniel P Judge
Johns Hopkins Hospital, Halsted 500D, 600 North Wolfe Street, Baltimore, MD 21287, USA; Djudge{at}jhmi.edu

An association between dilated cardiomyopathy and glucagonoma has not previously been described. A case of a 54 year old woman with tachycardia and congestive heart failure is described. Initial evaluation included an echocardiogram, which showed dilated cardiomyopathy with an ejection fraction of 15%. Coronary angiography and endomyocardial biopsy did not identify a secondary cause of her cardiomyopathy. She subsequently developed necrolytic migratory erythema, and imaging of her pancreas identified a pancreatic mass with a major increase of her serum glucagon concentration. Tachycardia persisted despite treatment with ß blockers. After resection of her tumour, her heart rate normalised and subsequently her heart returned to normal size and function. Glucagon is used to treat overdoses of ß blockers and calcium channel blockers, increasing heart rate by increasing myocardial cyclic AMP concentrations. Although rare, in the appropriate clinical setting, glucagonoma should be considered in the differential diagnosis for tachycardia and dilated cardiomyopathy.

Keywords: congestive heart failure; glucagonoma; reversible cardiomyopathy

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