Watery diarrhea, hypokalemia and achlorhydria syndrome due to an adrenal pheochromocytoma.
Watery diarrhea, hypokalemia and achlorhydria (WDHA) syndrome caused by vasoactive intestinal polypeptide (VIP) -producing tumor only rarely occurs in patients with nonpancreatic disease. A 49-year-old woman was referred for evaluation of a right adrenal tumor incidentally diagnosed by abdominal ultrasound during the investigation of chronic watery diarrhea. Laboratory findings showed hypokalemia and excessive production of VIP and catecholamines. After surgical resection of the tumor, diarrhea subsided and both electrolytes and affected hormone levels normalized. Immunohistochemical examination confirmed a diagnosis of pheochromocytoma, which contained VIP-positive ganglion-like cells. We herein present the clinical and histogenetic implications of this rare clinical entity, with literature review.
Ikuta
Shin-ichi
S
Department of Surgery, Meiwa General Hospital, Agenaruo 4-31, Nishinomiya, Hyogo, Japan. ikuta@meiwa-hospital.com
Yasui
Chiaki
C
Kawanaka
Masahiro
M
Aihara
Tsukasa
T
Yoshie
Hidenori
H
Yanagi
Hidenori
H
Mitsunobu
Masao
M
Sugihara
Ayako
A
Yamanaka
Naoki
N
D000126:Achlorhydria / Q000097:blood / Q000209:etiology* / Q000473:pathology; D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D000315:Adrenalectomy; D002395:Catecholamines / Q000097:blood; D003967:Diarrhea / Q000097:blood / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000097:blood / Q000209:etiology* / Q000473:pathology; D033162:Incidental Findings; D008875:Middle Aged; D010673:Pheochromocytoma / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014660:Vasoactive Intestinal Peptide / Q000097:blood; D003969:Vipoma / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000601:surgery
D002395:Catecholamines; D014660:Vasoactive Intestinal Peptide