title: McKittrick-Wheelock syndrome: a rare etiology of acute renal failure associated to well-differentiated adenocarcinoma (G1) arising within a villous adenoma.
abstract: BACKGROUND
  Large villous adenomas or adenocarcinomas of the rectum can determine secretory diarrhea, associated with a depleting syndrome of prerenal acute renal failure, hyponatremia, hypokalemia, and hypoproteinemia, with favorable prognosis if early detected and properly treated. The syndrome is rare, with approximately 50 cases reported in the literature.
  
  
  OBJECTIVE
  Acute renal failure, caused by fluids and electrolytes hypersecretion, secondary to a malignant rectal villous adenoma is revealed in a 55-year-old patient, admitted with major hydro-electrolytic and acid-base disturbances to our Nephrology Department.
  
  
  METHODS
  The 55-year-old male patient had a nine months history of mucous diarrhea, for which he was treated unsuccessfully by GP's and infectionists. The symptomatology aggravated progressively and the patient was admitted through ICU with oligoanuria, severe dehydration and hydro-electrolytic and acid-base disturbances. Rectosigmoidoscopy revealed a giant villous adenoma at the rectum. Conservative therapy initially improved, and finally normalized renal function and made possible surgical resection of the tumor, with an excellent evolution afterwards.
  
  
  CONCLUSIONS
  The McKittrick-Wheelock syndrome is a rare, life-threatening condition that requires interdisciplinary medical diagnosis and treatment, but has a good prognosis if renal function is recovered in time and makes possible curative tumoral resection.
authors: Department of Nephrology, Emergency County Hospital, Faculty of Medicine, Ovidius University, Constanta, Romania. tutaliliana@yahoo.com
authors: Liliana Ana
authors: LA
authors: Tuţă
authors: Mădălina
authors: M
authors: Boşoteanu
authors: Mariana
authors: M
authors: Deacu
authors: E
authors: E
authors: Dumitru
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000473:pathology*; D000230:Adenocarcinoma / Q000150:complications* / Q000473:pathology*; D018253:Adenoma, Villous / Q000150:complications* / Q000473:pathology*; D002454:Cell Differentiation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012812:Sigmoidoscopy; D013577:Syndrome