gastrins and Hypokalemia

Topics: Achlorhydria; Acromegaly; Adenoma; Adenoma, Islet Cell; Adolescent; Adult; Aged; Calcium; Cushing Syndrome; Diarrhea; Female; Gastric Acid; Gastrins; Glucagon; Humans; Hyperinsulinism; Hyperparathyroidism; Hypoglycemia; Hypokalemia; Male; Middle Aged; Neoplasms, Multiple Primary; Pancreatic Polypeptide; Pancreatitis; Parathyroid Glands; Parathyroid Neoplasms; Pituitary Neoplasms; Syndrome; Thyroid Diseases; Zollinger-Ellison Syndrome

Topics: Acute Kidney Injury; Adenoma, Islet Cell; Adolescent; Adult; Aged; Carcinoid Tumor; Child; Dehydration; Female; Gastric Inhibitory Polypeptide; Gastrins; Gastrointestinal Hormones; Gastrointestinal Neoplasms; Glucagon; Humans; Hyperplasia; Hypokalemia; Insulin; Insulin Secretion; Male; Middle Aged; Pancreatic Neoplasms; Paraneoplastic Endocrine Syndromes; Precancerous Conditions; Serotonin; Somatostatin; Syndrome; Vasoactive Intestinal Peptide; Zollinger-Ellison Syndrome

The Verner-Morrison Syndrome is a clinically defined entity caused by an islet cell tumor of the pancreas. More than 60 cases have been described so long. The syndrome is characterized by diarrhea, hypokalemia and hypochlorhydria. In addition to a diabetic disposition, raised calcium levels and skin alterations may be present. The diagnosis is a clinical one. A pancreatic tumor should be searched for and removed. Morphologically a benign and a maligne islet cell tumor or a diffuse hyperplasia of the islets of Langerhans can be found. Until now identification of the tumor cells has not been possible. There seems no doubt that the tumor cells produce a peptide hormone. Secretin, gastric inhibitory polypeptide, vasoactive intestinal polypeptide and combinations of hormones are discussed. The results are contradictory. Theories concerning the formal and causal pathogenesis are only incomplete and unproved up to now.

Topics: Achlorhydria; Adenoma, Islet Cell; Adolescent; Adult; Aged; Diarrhea; Female; Gastrins; Glucagon; Humans; Hypokalemia; Kidney Diseases; Male; Middle Aged; Pancreatic Neoplasms; Peptides; Pregnancy; Secretin; Syndrome

Topics: Achlorhydria; Acute Kidney Injury; Adenoma, Islet Cell; Adult; Cholecystokinin; Dehydration; Diarrhea; Gastrins; Gastrointestinal Hormones; Glucagon; Humans; Hypercalcemia; Hypokalemia; Kidney Diseases; Male; Pancreatic Neoplasms; Protein Precursors; Secretin; Syndrome; Zollinger-Ellison Syndrome

Topics: Angiography; Diarrhea; Gastrectomy; Gastric Acidity Determination; Gastrins; Humans; Hypokalemia; Islets of Langerhans; Pancreas; Recurrence; Zollinger-Ellison Syndrome

Topics: Adenoma, Islet Cell; Diarrhea; Digestive System; Fasting; Gastrins; Glucagon; Glucose; Glucose Tolerance Test; Humans; Hypoglycemia; Hypokalemia; Leucine; Pancreatic Neoplasms; Tolbutamide; Zollinger-Ellison Syndrome

Vipoma is a rare neuroendocrine tumor most frequently localized in the pancreas. When it is extrapancreatic, it is most often neurogenic. We report a case of primary extrapancreatic vipoma that is non neurogenic localized in the right liver in a patient with severe diarrhea and hypokaliema. Computed tomography, magnetic resonance imaging, intraoperative tomography and surgical exploration did not show any other extrahepatic primary lesion. The diagnosis was performed by immunochemistry, tumorous cells were positives with anti-VIP antibody. Forty two months after right hepatectomy, the patient was asymptomatic.

Topics: Adult; Antibodies, Neoplasm; Chromogranin A; Chromogranins; Diarrhea; Female; Gastrins; Hepatectomy; Humans; Hypokalemia; Immunohistochemistry; Liver Neoplasms; Magnetic Resonance Imaging; Serotonin; Tomography, X-Ray Computed; Treatment Outcome; Vipoma

A case of hypergastrinemia, diarrhea, and relentless hypokalemia occurring in a middleaged, mildly hypertensive female is described. The presence of a gastrinoma was suggested by the additional findings of an inordinate degree of hypokalemia for the amount of thiazide used for the treatment of her hypertension; failure of her hypokalemia to correct itself with adequate doses of oral potassium that had previously corrected this problem; and amelioration of her symptoms and hypokalemia when she was treated with short-term oral potassium chloride and longterm cimetidine.

Topics: Diarrhea; Female; Gastrins; Humans; Hypertension; Hypokalemia; Middle Aged; Zollinger-Ellison Syndrome

Three patients with the watery diarrhea-hypokalemia-achlorhydria (WDHA) syndrome were studied. All had watery diarrhea, hypokalemia and hypercalcemia. Plasma vasoactive intestinal polypeptide (VIP) levels determined by radioimmunoassay were markedly elevated in these patients, indicating that they had VIP-producing tumors. Plasma VIP levels determined serially after the operation indicate that its determination is useful in estimating the effect of a treatment. As for multiple endocrine neoplasia type 1 (MEN1), two out of the three cases belonged to this category. Patient 1 had a brother with insulinoma, and in case 2, even though there was no family history, the autopsy revealed not only multiple tumors of the pancreas but also pituitary adenomas, chief cell hyperplasia of the parathyroid glands, thyroid adenomas and adrenocortical adenomas. VIP and other hormones in the tumors as well as in the plasma were examined extensively in these cases. In case 1, VIP, gastrin and calcitonin were produced in the tumor and only plasma VIP levels were elevated. In case 2, with multiple tumors, tumor 1 produced VIP, glucagon pancreatic polypeptide, gastrin and calcitonin, and tumor 2, VIP, pancreatic polypeptide, gastrin and beta-melanocyte stimulating hormone. In this case, plasma VIP, pancreatic polypeptide and glucagon levels were elevated. In case 3, VIP and calcitonin were produced in the tumor, and plasma VIP and calcitonin levels were elevated. These results indicate that (1) VIP is a good tumor marker for the WDHA syndrome due to VIP-producing tumors; (2) patients with the WDHA syndrome are sometimes associated with MEN1; and (3) VIP-producing tumors are multiple hormone-producing tumors, and VIP predominantly elevated in the plasma results in the WDHA syndrome, although other hormones such as pancreatic polypeptide, glucagon and calcitonin are sometimes found to be elevated in plasma without contributing to the clinical features.

Topics: Achlorhydria; Adult; Calcitonin; Diarrhea; Female; Gastrins; Gastrointestinal Hormones; Glucagon; Humans; Hypokalemia; Insulin; Male; Middle Aged; Pancreatic Neoplasms; Parathyroid Hormone; Syndrome; Vasoactive Intestinal Peptide

1. Due to their common origin from the neural crest the hormonogenic cells of the intestinal tract show similar cyto-chemical and ultra-structural characteristics. 2. Hyperplasiae and tumors of these cells lead to excessive hormone production with its consequences on the reacting organs. 3. Hormone producing tumors can be confined to one organ only, but as multiple endocrine adenomatosis they can afflict several organs. 4. Diagnosis of most hormone producing tumors is possible with the adequate radio-immunologic tests. Radiologic and endoscopic examinations can contribute to the localization of the tumor. 5. Surgical resection of the tumor or of the reacting organs impaired by the overproduction of hormones from the tumor is the indicated therapy. Medicamentous therapy is rarely successful. 6. The growth of most hormonogenic tumors is relatively slow. Rates of survival of up to 30 years have been known, even after formation of metastases of the tumor. Effects of hormone overproduction on other organs can reduce the prognosis.

Topics: Adenoma; Carcinoid Tumor; Diarrhea; Gastrectomy; Gastrins; Humans; Hypokalemia; Intestinal Neoplasms; Multiple Endocrine Neoplasia; Pancreas; Paraneoplastic Endocrine Syndromes; Syndrome; Zollinger-Ellison Syndrome

Topics: Adenoma, Islet Cell; Aged; Dehydration; Diarrhea; Female; Gastrins; Humans; Hypercalcemia; Hypokalemia; Indomethacin; Prostaglandins E; Prostaglandins F; Syndrome

Topics: Adenoma, Islet Cell; Adult; Aged; Dehydration; Diagnosis, Differential; Diarrhea; Female; Fluorescent Antibody Technique; Gastrins; Humans; Hypokalemia; Islets of Langerhans; Male; Microscopy, Electron; Middle Aged; Neoplasm Metastasis; Pancreas; Pancreatic Neoplasms; Radioimmunoassay; Staining and Labeling; Syndrome; Zollinger-Ellison Syndrome

Topics: Achlorhydria; Animals; Diarrhea; Dogs; Gastric Juice; Gastrins; Gastrointestinal Hormones; Glucagon; Humans; Hypokalemia; Stimulation, Chemical; Water-Electrolyte Balance

Topics: Acidosis; Adenoma, Islet Cell; Adult; Autopsy; Diarrhea; Female; Fluorescent Antibody Technique; Gastric Juice; Gastrins; Gastrointestinal Hormones; Humans; Hypokalemia; Liver Neoplasms; Male; Neoplasm Metastasis; Pancreatic Neoplasms; Peptides; Radioimmunoassay; Secretin; Syndrome

Topics: Acute Kidney Injury; Adenoma, Islet Cell; Dehydration; Diarrhea; Female; Gastrins; Humans; Hyperglycemia; Hyperinsulinism; Hypokalemia; Insulin; Insulin Secretion; Kidney Diseases; Middle Aged; Multiple Endocrine Neoplasia; Pancreatic Neoplasms; Paraneoplastic Endocrine Syndromes; Zollinger-Ellison Syndrome

The clinical data are presented of two women with profound metabolic upset from exceptional water and electrolyte losses in diarrhoea. One had an islet-cell adenoma of the pancreas and the other abnormal islets. Gastric and pancreatic function were abnormal in both, consistent with the subsequent demonstration of a pancreatic and choleretic secretagogue in the tumour tissue and pancreatic and gastric secretagogues in circulating blood (Cleator, Thomson, Sircus, and Coombes, 1970).

Topics: Adenoma, Islet Cell; Adult; Diarrhea; Female; Gastrins; Humans; Hypercalcemia; Hypokalemia; Hyponatremia; Islets of Langerhans; Pancreas; Pancreatic Diseases; Pancreatic Neoplasms; Peptides; Radionuclide Imaging; Water-Electrolyte Balance

Topics: Adenoma, Islet Cell; Diarrhea; Gastrins; Humans; Hypokalemia; Pancreas; Pancreatic Diseases; Pancreatic Neoplasms; Secretin; Zollinger-Ellison Syndrome

Topics: Achlorhydria; Adenoma, Islet Cell; Animals; Biological Transport, Active; Cell Membrane Permeability; Cholecystokinin; Diarrhea; Gallbladder; Gastrins; Gastrointestinal Hormones; Hypokalemia; Rabbits; Secretin; Tissue Extracts

Topics: Adenoma, Islet Cell; Diarrhea; Duodenal Ulcer; Endoplasmic Reticulum; Gastrins; Humans; Hypokalemia; Liver; Microscopy, Electron; Neoplasm Metastasis

The production of ACTH-like material by tumours arising in non-endocrine tissue may initiate severe adrenocortical hyperfunction. The pathogenesis and clinical and laboratory features of Cushing's syndrome associated with such tumours are characteristic. The autonomous production by the tumour of ACTH-like material cannot be suppressed by exogenous corticoids. The onset of clinical symptoms is rapid; muscle wasting, general weakness, thirst and peripheral edema predominate, and the classical signs of Cushing's syndrome may be absent. High levels of plasma 17-hydroxycorticosteroids and urinary 17-hydroxycorticosteroids and 17-ketosteroids, usually with normal levels of urinary aldosterone, commonly occur. Hypokalemic alkalosis unresponsive to replacement therapy may cause death. In the case reported herein, the intriguing possibility exists that two hormone-like substances were produced by the primary growth and its metastases: one, ACTH-like, to account for the adrenal hyperplasia and Cushing's syndrome; and another, gastrin-like, giving rise to the ulcerogenic diathesis.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma, Islet Cell; Adrenalectomy; Adrenocortical Hyperfunction; Autopsy; Carcinoma, Islet Cell; Chloramphenicol; Cushing Syndrome; Drug Therapy; Gastrins; Humans; Hypokalemia; Neoplasm Metastasis; Neoplasms; Pancreatic Neoplasms; Pathology; Spironolactone; Zollinger-Ellison Syndrome

It is suggested that there are two hormonal syndromes associated with noninsulin-secreting islet cell tumours and this case is an example of the non-gastrin-secreting type with watery diarrhoea and hypokalaemia. The patient had histamine-fast achlorhydria and a normal gastric biopsy and no gastrin was recovered from the tumour tissue. The watery diarrhoea was isosmotic with plasma and was increased by an intravenous saline load. There was a dramatic response to steroids.

Topics: Achlorhydria; Adenoma, Islet Cell; Aldosterone; Cortisone; Dexamethasone; Diarrhea; Feces; Gastrins; Humans; Hypocalcemia; Hypokalemia; Neoplasms; Pancreatic Neoplasms; Potassium; Prednisone; Sodium; Surgical Procedures, Operative; Urine; Water-Electrolyte Balance; Zollinger-Ellison Syndrome