title: Hypokalemic rhabdomyolysis without watery diarrhea: an unexpected presentation of a pancreatic neuro-endocrine tumor.
abstract: Pancreatic polypeptide (PP) islet cell tumors are usually not associated with a distinct clinical syndrome, although some reports suggest that they can cause a watery diarrhea syndrome similar to vasoactive intestinal polypeptide (VIP) cell tumors. We report the case of a young woman with an unusual presentation of a pancreatic neuroendocrine tumor mainly secreting PP. The patient developed a reversible hypokalemic rhabdomyolysis very likely secondary to the presence of the tumor. The myopathy resolved following the restoration of normokaliemia using potassium supplementation and a partial laparoscopic pancreasectomy. Isolated cases of hypokalemic rhabdomyolysis induced by intestinal diseases have been described in literature but these did not include gastroenteropancreatic neoplasms. We suggest that pancreatic neuroendocrine tumors should be added to the list of intestinal diseases capable of producing hypokalemic myopathy.
authors.affiliation: Department and Chair of Rheumatology, Gaetano Pini Institute, University of Milan, Milan, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Rossi
authors.forename: Simone
authors.initials: S
authors.lastname: Saibeni
authors.forename: Luigi
authors.initials: L
authors.lastname: Sinigaglia
authors.forename: Maddalena
authors.initials: M
authors.lastname: Peracchi
authors.forename: Antonina
authors.initials: A
authors.lastname: Parafioriti
authors.forename: Maurizio
authors.initials: M
authors.lastname: Vecchi
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000209:etiology*; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000209:etiology*; D007205:Indium Radioisotopes; D018358:Neuroendocrine Tumors / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D015282:Octreotide; D010179:Pancreas / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010191:Pancreatic Polypeptide / Q000097:blood*; D011877:Radionuclide Imaging; D012206:Rhabdomyolysis / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D014660:Vasoactive Intestinal Peptide / Q000097:blood*
chemical_list: D007205:Indium Radioisotopes; D014660:Vasoactive Intestinal Peptide; D010191:Pancreatic Polypeptide; D015282:Octreotide