Pathogenesis

Glucagonoma is caused by glucagons-secreting tumors of the pancreatic islet. Glucagon stimulates hepatic gluconeogenesis and inhibits glucose breakdown and glycogen synthesis. The development of diabetes results from the actions of glycogen, as well as the relative concentrations of insulin and glucagon, which determines the net effect of hepatic glucose production (19). Weight loss is the result of the catabolic effects of glucagon, and anemia, the result of suppression of bone marrow erythropoiesis, again by glucagon, itself. The etiology of NME by glucagon has not been well established, although normalization of glucagon levels postresection often results in clearance of the skin lesions. Fatty acid deficiency, zinc deficiency, hepatic impairment, and amino acid deficiency also have been found to be important factors in NME development.

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