Ischemic stroke as a presenting feature of VIPoma due to MEN 1 syndrome

Abstract

Introduction:Presentation of the ischemic stroke due to vasoactive intestinal peptide producing tumor (VIPoma) or Verner Morrison syndrome is rare. This is first of its kind case which we are reporting here which was later turned out to be multiple endocrine neoplasia type 1 (MEN 1) syndrome with diagnosis of primary hyperparathyroidism in the same patient in follow-up.Description of the Case:A 13-year-old girl presented to our emergency department with features of disorientation, weakness of left sided extremities. She had watery high volume diarrhea and related dehydration with renal failure. Blood chemistry was suggestive of hypokalemia with metabolic acidosis. Patient had flushing on her face during this episode of illness. Magnetic resonance imaging (MRI) of brain suggested venous infarct. Computed tomography (CT) scan of abdomen done with high index of suspicion was suggestive of mass in tail of pancreas mostly a VIPoma. Patient was operated for the tumor after which there was no recurrence of diarrhea. Biopsy of tumor was consistent with VIPoma with chomogranin A positivity. Patient improved of her stroke episode with time. On follow-up she is diagnosed to have primary hyperparathyroidism with hypercalcemia due to left inferior parathyroid adenoma which improved with intravenous (IV) zolindronic acid therapy and now she is planned to undergo parathyroidectomy.Conclusion:VIPoma is a rare tumor but is well-described with MEN 1. Stroke as a presenting feature of VIPoma is first reported with this case.

Prevalence of diagnostic methods and treatment modalities in vipoma patients: A rare cause of hormone-mediated diarrhea

“…Of these, 15 patients (15/30, 50%) were male and 15 patients (15/30, 50%) were female [Figure 2]. [23456789101112131415161718192021222324252627282930]…”

Ventricular fibrillation resulting from electrolyte imbalance reveals vipoma in MEN1 syndrome

“…Ischemic stroke as a presenting symptom of VIPoma has recently been reported in a 13-year old girl [21]. Notably, our case is the first description of potentially lethal ventricular fibrillation due to chronic diarrhea, caused by VIPoma in MEN1, both extremely rare conditions of which the patient was unaware.…”

Neuroangiogenesis in endometrium of women with endometriosis and chronic pelvic pain: high expression of vasoactive intestinal peptide

“…На основании полученных результатов была сформирована гипотеза о наличии у больных с эндометриозом и хронической тазовой болью схожих признаков сверхэкспрессии VIP и нейродегенерации. Следовательно, эндометриоз следует отнести к ассоциированным с VIP заболеваниям: випома (синдром Вернера-Моррисона), рассеянный склероз, артриты, хроническая обструктивная болезнь легких (ХОБЛ) [8,14,29,33,43]. Последующие исследования природы этого явления позволят подтвердить или опровергнуть вы-сказанное предположение.…”