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[McKittrick-Wheelock syndrome].

Renée M Barendse1, Stephanie van den Brandt, Evelien Dekker

  • 1AMC, afd. Maag-, Darm- en Leverziekten, Amsterdam, the Netherlands.

Nederlands Tijdschrift Voor Geneeskunde
|January 19, 2013
PubMed
Summary

McKittrick-Wheelock syndrome, a rare condition involving large rectal villous adenomas, can cause severe electrolyte imbalance and renal failure. Prompt endoscopic resection can effectively treat these symptoms.

Area of Science:

  • Gastroenterology
  • Nephrology
  • Endocrinology

Background:

  • McKittrick-Wheelock syndrome is a rare disorder characterized by excessive fluid and electrolyte secretion from large rectal villous adenomas.
  • Untreated, it can lead to life-threatening complications such as renal failure and cardiac arrhythmias.

Observation:

  • Two cases are presented: an 83-year-old female with dehydration and electrolyte imbalance, and a 66-year-old male with malaise, weight loss, and severe renal failure.
  • Both patients were found to have extensive rectal adenomas.
  • Endoscopic mucosal resection was performed for both patients.

Findings:

  • Following endoscopic mucosal resection, the female patient's electrolyte levels normalized.
  • The male patient experienced resolution of electrolyte imbalance and normalization of renal function post-resection.

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  • A fibrotic remnant in the male patient required surgical removal, revealing a submucosally invasive carcinoma.

    • Implications:

    • Large rectal adenomas can be an uncommon cause of renal failure and electrolyte disturbances.
    • Endoscopic mucosal resection is an effective treatment for McKittrick-Wheelock syndrome.
    • Early diagnosis and intervention are crucial to prevent severe complications.