vasoactive-intestinal-peptide and Gastroenteritis

As case report we describe a rare cause of intractable "gastroenteritis" detected by ultrasonography. The 14 months-old boy was admitted to hospital because of intensive dehydration due to massive vomiting and diarrhoea. A salmonella enteritis with intractable hyponatraemia and hypokalaemia was thought to be the cause. After a dramatic relapse during oral treatment measures, further extensive laboratory tests finally disclosed an elevated serum level of vasoactive intestinal polypeptide ("VIP"). The VIP secreting tumor ("VIPoma") was detected ultrasonographically in a retroperitoneal localization mediocaudally of the right kidney. Diffuse distinct calcifications and an increased perfusion could be demonstrated. Intraspinal tumour spread was excluded by magnetic resonance imaging. After complete surgical removal of the tumour the clinical symptomatology normalized promptly and permanently. A VIP-excreting ganglioneuroblastoma with low grade growth fraction ("VIPoma") was diagnosed histologically. Common gastroenteritis in childhood represents no indication for ultrasound. In cases of unclear and therapy-resistant symptomatology, however, diagnostic work-up should include ultrasonography to search for retroperitoneal or pancreatic VIP-excreting tumours.

Topics: Gastroenteritis; Humans; Infant; Magnetic Resonance Imaging; Male; Pancreatic Neoplasms; Ultrasonography; Vasoactive Intestinal Peptide; Vipoma

The study was performed on 20 piglets of both sexes. The control group consisted of 10 healthy piglets, the experimental, group included 10 piglets with symptoms of gastroenteritis. All the animals were subjected to euthanasia at the age of 21 or 35 days (weaning), or 7 days after weaning, and immunohistochemical and histopathological examinations were performed on all of them. Immunohistochemical examinations of the experimental piglets included additional tests made on five piglets with gastroenteritis, characterized by poor general condition. Histopathological examinations of the pancreas revealed retrogressive changes, which might result from hemodynamic disorders. Changes in the localization of SOM and VIP found in the pancreas suggested inhibition of pancreatic enzyme synthesis in piglets with diarrhea. The co-localization of GAL and dopamine beta-hydroxylase (D beta H--a key enzyme of the noradrenaline synthesis pathway) in perivascular nerve fibers could lead to considerable vasospasms in the pancreas, resulting in deeper hypoxia of the organ. Immunohistochemical and histopathological examinations confirmed the results of biochemical analyses, indicating failure of the pancreatic exocrine function in piglets with gastroenteritis.

Topics: Animals; Case-Control Studies; Diarrhea; Dopamine beta-Hydroxylase; Female; Galanin; Gastroenteritis; Immunohistochemistry; Male; Metabolic Diseases; Pancreas; Somatostatin; Swine; Swine Diseases; Vasoactive Intestinal Peptide