McKittrick-Wheelock syndrome - a rare cause of acute renal failure.
OBJECTIVE
Fluid and electrolyte hypersecretion in the villous adenoma of the rectum is presented in the case of a 74 year old man presenting with a severe fluid imbalance.


METHODS
The patient had a 2-year history of mucous diarrhea and, on admission, presented prerenal uremia, hyponatremia and severe hypokalemia. At sigmoidoscopy, a 6/4 cm villous adenoma of the rectum was found. The increased loss of volume, followed by exhaustion of the physiological compensation mechanisms, led to a life-threatening hypokalemia, as well as to acute renal failure. Conservative treatment was followed by a temporary improvement of the renal function. Alternative treatment was: endocavitary irradiation, endoscopic resection and radical tumor surgery. The surgical removal of the adenoma led to complete recovery of the symptoms.


CONCLUSIONS
The McKittrick-Wheelock syndrome can be a problem of difficult diagnosis, both for the gastroenterologist and also for the nephrologist. The patient may develop severe complications, which require a sustained treatment.
Popescu
Alina
A
Gastroenterology, Hepatology and Endoscopy Clinic of the Elias Hospital, Bd. Marasti 17, Bucharest, Romania. alina@swissinfo.org
Orban-Schiopu
Ana-Maria
AM
Becheanu
Gabriel
G
Diculescu
Mircea
M
D058186:Acute Kidney Injury / Q000209:etiology*; D000236:Adenoma / Q000150:complications*; D000368:Aged; D003967:Diarrhea / Q000209:etiology; D004573:Electrolytes; D005440:Fluid Therapy; D006801:Humans; D007008:Hypokalemia / Q000209:etiology; D007010:Hyponatremia / Q000209:etiology; D008297:Male; D012004:Rectal Neoplasms / Q000150:complications*; D013577:Syndrome; D014511:Uremia / Q000209:etiology; D014882:Water-Electrolyte Balance
D004573:Electrolytes