MCKITTRICK-WHEELOCK SYNDROME: A RARE CAUSE OF POTENTIALLY FATAL CHRONIC DIARRHEA

• DOI: 10.22533/at.ed.1593282318047

• Palavras-chave: McKittrick-Wheelock syndrome; Electrolyte depletion syndrome; Secretory villous adenoma; Hydroelectrolytic imbalance; chronic diarrhea

• Keywords: McKittrick-Wheelock syndrome; Electrolyte depletion syndrome; Secretory villous adenoma; Hydroelectrolytic imbalance; chronic diarrhea

• Abstract:

  McKittrick-Wheelock syndrome is characterized by a state of extreme fluid and electrolyte depletion secondary to large colorectal tumors, often benign villous adenoma. It was first reported in 1954 by McKittrick and Wheelock. Patients present with chronic diarrhea, severe hyponatremia, hypokalemia, and/or acute kidney injury. This work consists of an elaborate bibliographic review, in order to elucidate what is known about this pathology classified as rare. It aims to improve the diagnosis and management of this potentially lethal syndrome and to understand its presentation and pathophysiology, in order to allow the physician to anticipate the patient's deterioration. Pathophysiologically, there is hypersecretion of prostaglandin E2 in secretory tubulovillous adenomas. However, it remains an uncommon and poorly recognized disease, presenting significant morbidity if not properly treated. Due to the long period between the onset of symptoms and diagnosis, therapy ends up being delayed. Definitive treatment, which often proves to be curative, must be performed after the patient has stabilized, by means of tumor resection. After fluid and electrolyte replacement and early definitive surgery, the prognosis tends to be good.