title: Watery diarrhea, hypokalemia and achlorhydria syndrome due to an adrenal pheochromocytoma.
abstract: 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.
authors.affiliation: Department of Surgery, Meiwa General Hospital, Agenaruo 4-31, Nishinomiya, Hyogo, Japan. ikuta@meiwa-hospital.com
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Ikuta
authors.forename: Chiaki
authors.initials: C
authors.lastname: Yasui
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kawanaka
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Aihara
authors.forename: Hidenori
authors.initials: H
authors.lastname: Yoshie
authors.forename: Hidenori
authors.initials: H
authors.lastname: Yanagi
authors.forename: Masao
authors.initials: M
authors.lastname: Mitsunobu
authors.forename: Ayako
authors.initials: A
authors.lastname: Sugihara
authors.forename: Naoki
authors.initials: N
authors.lastname: Yamanaka
mesh_terms: 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
chemical_list: D002395:Catecholamines; D014660:Vasoactive Intestinal Peptide