What is Morrison syndrome?
The VIPoma syndrome, also called the Verner-Morrison syndrome, pancreatic cholera, and the WDHA syndrome (for watery diarrhea, hypokalemia, and achlorhydria), results from an endocrine tumor, usually in the pancreas that ectopically secretes vasoactive intestinal polypeptide (VIP).
What are the symptoms of VIPoma?
Symptoms of VIPoma may include any of the following:Abdominal pain and cramping.Diarrhea (watery, and often in large amounts)Dehydration.Flushing or redness of the face.Muscle cramps due to low blood potassium (hypokalemia)Nausea.Weight loss.
How is VIPoma diagnosed?
Computed tomography (CT), magnetic resonance imaging (MRI), and somatostatin receptor scintigraphy are imaging modalities that can be used in the diagnosis of VIPoma. Reports have demonstrated successful VIPoma localization with99m Tc sestamibi. No formal staging criteria for VIPoma have been generally accepted.
Is VIPoma treatable?
Surgery. Surgery is the main treatment for VIPomas. There are different types of operations depending on where the tumour is.
What are the signs and symptoms of carcinoid syndrome?
The most common signs and symptoms include:Skin flushing. The skin on your face and upper chest feels hot and changes color — ranging from pink to purple. ... Facial skin lesions. Purplish areas of spiderlike veins may appear on your nose and upper lip.Diarrhea. ... Difficulty breathing. ... Rapid heartbeat.
Are VIPomas cancerous?
What are VIPomas? VIPomas are rare cancers that start in the neuroendocrine cells that make the hormone VIP. VIP stands for vasoactive intestinal peptide. It relaxes the muscles in the stomach and bowel, and helps to control the balance of sugar, salt and water in the gastrointestinal (GI) tract.
How do you treat VIPoma?
Initial treatment of VIPomas is directed toward correcting volume and electrolyte abnormalities. Octreotide acetate controls diarrhea in up to 90% of patients with VIPomas. Glucocorticoids reduce symptoms in 50%. Systemic chemotherapy may be needed in cases of unresectable or progressive disease.
Can you have a VIPoma without diarrhea?
Vasoactive intestinal polypeptide-secreting tumors (VIPoma) are a rare pancreatic neuroendocrine tumor that can cause chronic diarrhea with 1 case per 10 million people per year.
Where are VIPomas located?
VIPoma is a very rare cancer that usually grows from cells in the pancreas called islet cells. The pancreas is an elongated, tapered gland that is located behind the stomach and secretes digestive enzymes and the hormones insulin and glucagon.
How does VIPoma cause diarrhea?
VIP is a 28 amino acid polypeptide that binds to high affinity receptors on intestinal epithelial cells, leading to activation of cellular adenylate cyclase and cAMP production. This results in net fluid and electrolyte secretion into the lumen, resulting in secretory diarrhea and hypokalemia [12,13].
Is VIPoma genetic?
This is often a genetic condition that runs in families. VIPoma: A type of neuroendocrine pancreatic tumor that secretes vasoactive intestinal polypeptide (VIP). This leads to severe intermittent diarrhea that causes further problems, including dramatic potassium loss.
Why does Gastrinoma cause diarrhea?
These tumors, called gastrinomas, secrete large amounts of the hormone gastrin, which causes your stomach to produce too much acid. The excess acid then leads to peptic ulcers, as well as to diarrhea and other symptoms.
How do you treat VIPoma?
Initial treatment of VIPomas is directed toward correcting volume and electrolyte abnormalities. Octreotide acetate controls diarrhea in up to 90% of patients with VIPomas. Glucocorticoids reduce symptoms in 50%. Systemic chemotherapy may be needed in cases of unresectable or progressive disease.
What causes high VIP levels?
A very high level is usually caused by a VIPoma . This is an extremely rare tumor that releases VIP. VIP is a substance found in cells throughout the body. The highest levels are normally found in cells in the nervous system and gut.
How do I confirm my VIPoma account?
MRI scan. An MRI scan takes detailed pictures of the body. You might have an MRI scan to check if the VIPoma has spread to other parts of the body such as the liver and lymph nodes.
What does VIP hormone do?
A hormone found in the pancreas, intestine, and central nervous system. It has many actions in the body, such as helping to control the secretion of water, salts, enzymes, and gastric acid during digestion. It also causes smooth muscles in the digestive tract, the heart, and the blood vessels to relax.
How long does Werner-Morrison syndrome last?
Werner-Morrison syndrome should be suspected in the presence of diarrhea for at least 3 weeks and with a daily stool volume of at least 0.7 liters (or 0.7 kg mass). The test with fasting for 3 days (all this time the loss of water and electrolytes is compensated for by parenteral administration) does not lead to a decrease in the daily volume of stool below 0.5 l. Hypo-or achlorhydria is proven by examining gastric secretion. The final diagnosis is established when a high content of VIP in the plasma is detected. The normal concentration of VIPs requires the exclusion of elevated plasma levels of PP and prostaglandin E.
What is the best treatment for Werner-Morrison syndrome?
In patients with Werner-Morrison syndrome caused by a tumor producing prostaglandin E, good results are reported when treated with an inhibitor of the synthesis of prostaglandins - indomethacin (50 to 200 mg / day inwards).
How does cholera vibrio affect the body?
Only in 20% of cases the volume of stool is less than 3 liters per day. Due to dehydration of the body, patients quickly lose body weight. Together with water, potassium and sodium are excreted from the body. As a result, hypokalemia, metabolic acidosis and hypohydration develop, which in turn can lead to cardiovascular, renal insufficiency. Diarrhea is often accompanied by pain in the abdomen. It is caused by the influence of VIP on the water-sodium flow in the small intestine - instead of absorbing water and electrolytes, it causes their secretion. The effect of a polypeptide, like that of cholera vibrio toxins , is accomplished by stimulating adenylate cyclase of cell membranes. A similar mechanism of action of both factors explains the similarity of the clinical manifestations of the two diseases.
How long does it take to recover from Werner Morrison syndrome?
Untreated patients with Werner-Morrison syndrome die within a few months. Complete recovery occurs only after a radical operation, if it is possible, which is observed in 30% of cases. With an inoperable tumor, cytostatic therapy with streptozotocin is performed. Chemotherapy can induce a remission phase within a few years. In cases of vipoma resistance to treatment with streptozotocin, primary or developing against previously successful therapy, it is often possible to keep diarrhea under control, at least temporarily, with corticosteroids (prednisolone 20 to 60 mg).
What is the name of the disease that manifests itself as severe water-resistant diarrhea, hypokalemia, and gas?
Werner-Morrison syndrome is a disease that manifests itself as severe water-resistant diarrhea, hypokalemia, and gastric chlorhydria or hypochlorhydria and is also called WDHA or WDHH syndrome (Hypokalemia Achlorhydria, Hypochlorhydria). Because of its significant similarity with cholera, one more synonym is used - "pancreatic cholera".
Can Werner-Morrison syndrome cause increased vip?
Increased VIP content in plasma , in addition to Werner-Morrison syndrome, is possible in patients with mesenteric infarction and with shock. This pathology is characterized by acute development of symptoms.
Symptoms and signs
The major clinical features are prolonged watery diarrhea (fasting stool volume > 750 to 1000 mL/day) and symptoms of hypokalemia and dehydration . Half of the patients have relatively constant diarrhea while the rest have alternating periods of severe and moderate diarrhea .
Diagnosis
Besides the clinical picture, fasting VIP plasma level may confirm the diagnosis, and CT scan and somatostatin receptor scintigraphy are used to localise the tumor, which is usually metastatic at presentation.
Treatment
The first goal of treatment is to correct dehydration. Fluids are often given through a vein (intravenous fluids) to replace fluids lost in diarrhea. The next goal is to slow the diarrhea. Some medications can help control diarrhea. Octreotide, which is a human-made form of the natural hormone somatostatin, blocks the action of VIP.
Prognosis
Surgery can usually cure VIPomas. However, in one-third to one-half of patients, the tumor has spread by the time of diagnosis and cannot be cured.
What Is Verner-Morrison Syndrome?
- Verner-Morrison syndrome is a very rare neuroendocrine tumor of the pancreas. It is a tumor of the neuroendocrine system, which includes the nervous and endocrine systems. This tumor is also known as a VIPoma because it produces an increased amount of the hormone VIP. For all you need to know about methanol poisoning, please visit phonecations.com....
Causes
- Little is known about the causes of Verner-Morrison syndrome. It is the malignant degeneration of D1 cells in the pancreas. The D1 cells are responsible for producing the VIP hormone. Under physiological conditions, VIP synthesis is subject to hormonal regulation mechanisms. Among other things, the growth hormone has an inhibiting effect on the formation of VIP. However, the t…
Symptoms, Ailments & Signs
- The characteristic symptom of Verner-Morrison syndrome is massive and persistent diarrhea that is similar to cholera. The large loss of fluids from the body and the hypokalemia cause abdominal cramps and states of confusion in addition to diarrhea. Other symptoms include muscle cramps, severe tiredness, vomiting and cardiac arrhythmias. The disease can be fatal. Here, the loss of fl…
Diagnosis & Course of Disease
- Diagnosing Verner-Morrison syndrome is difficult because the condition is so rare. The suspicion of VIPoma is often not mentioned at all. However, if there is persistent and massive diarrhea that does not go away, Verner-Morrison syndrome should also be considered. The determination of chromogranin A also provides valuable information. Because this substance is produced by all n…
Complications
- In Verner-Morrison syndrome, those affected primarily suffer from very severe diarrhea. This has a very negative effect on the patient’s quality of life and makes everyday life considerably more difficult. As a rule, those affected lose a lot of fluids as a result, which in turn can promote severe dehydration and deficiency symptoms if the nutrients are not substituted elsewhere. There is als…
When Should You Go to The Doctor?
- Since Verner-Morrison syndrome cannot heal on its own, those affected should definitely consult a doctor. The sooner treatment is given, the better the further course of the disease. In the worst case, the person concerned dies as a result of Verner-Morrison syndrome if this is not treated. A doctor should be contacted for this disease if the patient suffers from persistent diarrhea. This …
Treatment & Therapy
- Therapy for Verner-Morrison syndrome depends on the condition of the tumor. If the tumor is detected early, there is a good chance that metastases have not yet formed. In this case, a complete cure can be achieved by surgically removing the tumor. If metastases are already present, an operation no longer makes sense. Then there is the option of treating the tumor wit…
Prevention
- There is no recommendation for prevention of Verner-Morrison syndrome. The causes of the degeneration of the D1 cells are not yet known.
Aftercare
- Follow-up care for Verner-Morrison syndrome depends on the therapy. Rest and relaxation are important after an operation. A further physical examination takes place during the follow-up visit. Imaging procedures are used to determine whether further metastases are present. If the tumors do not metastasize and do not recur, no further follow-up is necessary. The patient only has to …
You Can Do That Yourself
- Verner-Morrison syndrome requires medical treatment in the first place. The treatment of the malignant tumor can be supported by a number of self-help measures. First of all it is important to avoid stress. Patients should rest extensively and otherwise comply with the doctor’s instructions. These usually also affect the intake of sufficient liquid, since the tumor leads to severe dehydrat…