A Case of WDHA Syndrome Associated with Multiple Endocrine Neoplasia

Hideo Matsumoto, Shuichi Nomura, Shinichirou Tanaka, Isamu Nagahiro*, Ryuuji Hirai*, Hideki Itano, Sumiji Sasaki

Department of Surgery, Okayama National Hospital
*Second Department of Surgery, Okayama University School of Medicine

A case of watery diarrhea, hypokalemia and achlorhydria (WDHA) syndrome, associated with primary hyperparathyroidism, is reported. A 7l-year-old man was introduced to our department of surgery because of watery diarrhea. A mass in the head of the pancreas was detected with ultrasonography and magnetic resonance imaging (MRI). Moreover, swelling of the parathyroids was observed, although abnormal findings of pituitary gland were not remarkable. From laboratory data, hyperglycemia and hypokalemia were diagnosed and also the levels of vasoactive intestinal polipeptide (VIP) and parathyroid hormone (PTH) were very high in the serum, 1450 ng/ml and 8300 pg/ml, respectively. First, pancreaticoduodenectomy and later total parathyroidectomy in combination with autotransplantation of the parathyroid were performed. The procedure ameliorated the watery diarrhea and normalized the serum levels of VIPA and PTH. This is a case of multiple endocrine neoplasms (MEN) Type 1, consisting of the pancreatic VIP oma and hyperplasia of the parathyroid.

Key words
watery diarrhea hypokalemia achlorhydria syndrome, hyperparathyroidism, multiple endocrine neoplasm type 1

Reprint requests
Hideo Matsumoto Second Department of Surgery, Okayama University School of Medicine
2-5-1 Shinkata-cho, Okayama City, 700 JAPAN

Accepted
May 17, 1995

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