Watery diarrhea, hypokalemia and achlorhydria syndrome due to an adrenal pheochromocytoma.

Shin-ichi Ikuta, Chiaki Yasui, Masahiro Kawanaka, Tsukasa Aihara, Hidenori Yoshie, Hidenori Yanagi, Masao Mitsunobu, Ayako Sugihara, Naoki Yamanaka

Journal: World journal of gastroenterology 2007;13(34):4649-52

PMID: 17729424

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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.

Address: Department of Surgery, Meiwa General Hospital, Agenaruo 4-31, Nishinomiya, Hyogo, Japan. [email protected]

DOI: 10.3748/wjg.v13.i34.4649

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MeSH Terms: Achlorhydria, Adrenal Gland Neoplasms, Adrenalectomy, Catecholamines, Diarrhea, Female, Humans, Hypokalemia, Incidental Findings, Middle Aged, Pheochromocytoma, Tomography, X-Ray Computed, Treatment Outcome, Vasoactive Intestinal Peptide, Vipoma