McKittrick-Wheelock Syndrome: A Case Series

Villanueva, Maureen Elvira P; Onglao, Mark Augustine S; Tampo, Mayou Martin T.; Lopez, Marc Paul Jose

doi:10.3393/ac.2020.00745.0106

Cited by 7 publications

(20 citation statements)

References 16 publications

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“…In our reported case, the patient was also admitted to the hospital due to electrolyte imbalance. However, there are referred cases in the literature with an atypical presentation of MWS at the emergency department with rectal prolapse, dermatomyositis, or with encephalopathy due to severe hyponatremia [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recently published studies have shown an increase in the usage of minimally invasive procedures such as transanal endoscopic microsurgery, transanal minimally invasive surgery, endoscopic mucosal resection, and endoscopic submucosal dissection [ 21 , 22 ]. However, some authors noticed that the risk of recurrence is greater after minimally invasive operations [ 4 , 9 , 18 ]. Endoscopic techniques may be technically challenging due to the large size of the tumor in MWS patients [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, some authors noticed that the risk of recurrence is greater after minimally invasive operations [ 4 , 9 , 18 ]. Endoscopic techniques may be technically challenging due to the large size of the tumor in MWS patients [ 18 ]. In our case, laparoscopic-assisted surgery was chosen.…”

Section: Discussionmentioning

confidence: 99%

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McKittrick–Wheelock Syndrome: A Case Report

2023

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An adenoma is the most typical large bowel tumor found in 30% of all screening colonoscopies. However, it is often asymptomatic but sometimes might lead to abdominal pain or bleeding of the rectum. Critical electrolyte disbalance and acute kidney injury caused by secretory diarrhea is an untypical clinical manifestation of adenoma. It has rarely been reported in the literature and is defined as McKittrick–Wheelock syndrome. A 61-year-old patient was hospitalized for heavy dyselectrolytemia, diarrhea, acute kidney injury, sepsis, and fever. After the renal function was corrected and electrolyte imbalance persisted, visual instrumental diagnostics tests revealed a large tumor in the sigmoid colon. Subsequently, the patient underwent surgical resection, which exhibited evidence of tubulovillous adenoma on pathology. The atypical signs of McKittrick–Wheelock syndrome and comorbidities can make the diagnostics challenging. When severe hyponatremia and hypokalemia are followed by persistent mucous diarrhea, the clinicians should suspect MWS as a possible reason for it.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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McKittrick–Wheelock Syndrome: A Case Report

2023

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“…The AM would therefore have been responsible in our patient for an equivalent of the electrolyte depletion syndrome (Mckittrick-Wheelock syndrome). This latter is a rare and life-threatening disease characterized by the triad of (1) chronic mucous diarrhea, (2) renal function impairment with hydroelectrolyte imbalance, and (3) a giant colorectal tumor ( Villanueva et al, 2022 ). The mechanism behind severe electrolyte and body fluid depletion in Mckittrick-Wheelock syndrome is suggested to involve cyclic adenosine monophosphate (AMP) and prostaglandin E2 acting as mediators, which increase the loss of fluid and electrolytes from the plasma to the intestinal lumen ( Steven et al, 1981 ).…”

Section: Discussionmentioning

confidence: 99%

Chronic Kidney Disease, Hypokalemia, and Appendicular Mucocele in a 66-Year-Old Man

2022

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Appendicular mucocele (AM) is a rare and potentially malignant entity linked to obstructive dilatation of the appendix with an intraluminal accumulation of mucoid material. Most AM is asymptomatic or simulates acute appendicitis. We report an exceptional case of AM discovered in the face of hypokalemia and aggravation of chronic kidney disease (CKD) without diarrhea in an old man. Investigations led to the diagnosis of AM in its malignant form complicated by gelatinous ascites. We retained mucinous hypersecretion as the cause of hypokalemia and acute renal failure. Aggressive surgery and intraperitoneal chemotherapy corrected hydroelectrolyte imbalance.

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“…Such a pathology is potentially lethal, so it is of paramount importance to have greater knowledge about the clinic, diagnosis and therapy. 31 In 1941, for the first time, an acute kidney injury caused by secretory diarrhea arising from a colorectal villous adenoma associated with an exacerbated decrease in electrolytes was described in a case report, which was called "pre-renal uremia due to rectal papilloma". Only in 1954 was this syndrome titled by the eponym "McKittrick and Wheelock".…”

Section: Introductionmentioning

confidence: 99%

McKittrick-Wheelock Syndrome: A Rare Cause of Potentially Fatal Chronic Diarrhea

Michelini¹,

Alvarez²

2023

JHS

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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.

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McKittrick-Wheelock Syndrome: A Case Series

Cited by 7 publications

References 16 publications

McKittrick–Wheelock Syndrome: A Case Report

McKittrick–Wheelock Syndrome: A Case Report

Chronic Kidney Disease, Hypokalemia, and Appendicular Mucocele in a 66-Year-Old Man

McKittrick-Wheelock Syndrome: A Rare Cause of Potentially Fatal Chronic Diarrhea

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