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[Acute renal failure caused by VIP-secreting tumor]
D Lambertini1, E Bottini, E Talassi
1U.O. di Nefrologia ed Emodialisi, Azienda Ospedaliera Carlo Poma, Mantova, Italy. dialisi@ospedale.mantova.it
Summary
A pancreatic VIP-secreting tumor caused severe dehydration and acute kidney injury in a patient. Early diagnosis and treatment, including surgery, are crucial for managing this rare neuroendocrine tumor.
Area of Science:
- Endocrinology
- Oncology
- Nephrology
Background:
- Vasoactive intestinal polypeptide (VIP)-secreting tumors, known as vipomas, are rare neuroendocrine neoplasms.
- These tumors can lead to severe and life-threatening complications due to excessive hormone secretion.
Observation:
- A 74-year-old woman presented with secretory diarrhea, metabolic acidosis, hypokalemia, and hypovolemia.
- These symptoms progressed to acute renal failure, directly linked to a pancreatic VIP-secreting tumor.
Findings:
- Diagnosis of vipoma requires documenting large-volume secretory diarrhea, elevated plasma VIP levels, and tumor localization.
- Metastases are identified in 50% of patients at diagnosis, highlighting the aggressive nature of the tumor.
Implications:
- Morbidity and mortality associated with vipoma are primarily due to dehydration, electrolyte disturbances, and acute renal failure.
- Effective management involves correcting fluid and electrolyte imbalances, managing acute renal failure (potentially with continuous venovenous hemodialysis), using medications to reduce gastrointestinal secretion, and surgical resection of the tumor.