时间 : 2009-11-26 14:05:10 来源:www.wooyao.org.cn
Case report 93 Diagnosis and treatment of VIPoma in a female patient Carol Ann Remmea,b, Gerrit H. de Groota and Gideon Schrijvera We report a case of
Casereport93DiagnosisandtreatmentofVIPomainafemalepatientCarolAnnRemmea,b,GerritH.deGrootaandGideonSchrijveraWereportacaseofVIPomainan83-year-oldfemalepatient,whopresentedwithfrequentandexcessivediarrhoea,muscleweakness,andseverehypokalaemia.Abdominalcomputedtomography(CT)revealeda46cmmassinthebodyofthepancreas.Laboratoryanalysisshowedelevatedlevelsofbothvasoactiveintestinalpolypeptide(VIP;153pmol/l)andpancreaticpolypeptide(161pmol/l).Inviewofthepatient’sage,physicalcondition,andtumoursize,surgicalresectionwasnotperformed.Thepatientwastreatedwithalong-actingoctreotide,afterwhichhersymptomsdiminished.After24monthsoffollow-up,thepatientremainedingoodphysicalconditionwithoutanyfurtherseriousgastrointestinalsymptoms.TheVIPomasyndromeiscausedbyaneuroendocrinetumour,usuallylocatedinthepancreas,whichsecretesVIP,causingseverediarrhoea,dehydrationandhypokalaemia.Treatmentoptionsincluderesectionofthetumour,chemotherapyorthereductionofsymptomswithsomatostatinanalogues.Weprovideanoverviewoftheincidence,pathophysiology,diagnosis,treatmentstrategies,andprognosisofthisraresyndrome.EurJGastroenterolHepatol18:93C99c2006LippincottWilliams
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