GCG and hyperhomocysteinemia: It is more likely that the prothrombotic state associated with glucagonomas is multifactorial which contributing factors include zinc depletion [13], a potential direct effect of glucagon on fibrinolysis [14], imbalanced reduction of prothrombotic and fibrinolytic factors associated with impaired liver protein synthesis capacity, hyperhomocysteinemia, and endothelial dysfunction from B12 deficiency related to malabsorption and malnutrition [15].