Abstract
A case of watery diarrhea, hypokalemia and achlorhydria (WDHA) syndrome, associated with primary hyperparathyroidism, is reported. A 71-year-old man was introduced to our department of surgery because of watery diarrhea. A mass in the head of the pancreas was detected with ultrasonography and magnetic resonance imaging (MRI). Moreover, swelling of the parathyroids was observed, although abnormal findings of pituitary gland were not remarkable. From laboratory data, hyperglycemia and hypokalemia were diagnosed and also the levels of vasoactive intestinal polipeptide (VIP) and parathyroid hormone (PTH) were very high in the serum, 1450 ng/ml and 8300 pg/ml, resp ctively. First, pancreaticoduodenectomy and later total parathyroidectomy in combination with autotransplantation of the parathyroid were performed. The procedure ameliorated the watery diarrhea and normalized the serum levels of VIPA and PTH. This is a case of multiple endocrine neoplasms (MEN) Type 1, consisting of the pancreatic VIP oma and hyperplasia of the parathyroid.
