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VIPoma — SCE Endocrinology MCQ

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HardNET/MENVIPomaSCE Endocrinology

A man has 4 litres of watery diarrhoea daily that persists during fasting, potassium 2.6 mmol/L, hyperchloraemic metabolic acidosis and low gastric acid secretion. Which secretory syndrome is most likely?

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Correct answer: B — VIP-secreting pancreatic neuroendocrine tumour

Fasting-persistent high-volume secretory diarrhoea, hypokalaemia and reduced gastric acid secretion form the WDHA syndrome of VIP excess. Confirmation requires a raised VIP level during symptoms after excluding more common secretory diarrhoea causes, followed by anatomical and somatostatin-receptor imaging.

Reference: Endotext: vasoactive intestinal peptide-secreting tumour (Updated 2023): https://www.ncbi.nlm.nih.gov/books/NBK278960/; Clinical practice guideline for multiple endocrine neoplasia type 1 (Published 2012): https://academic.oup.com/jcem/article/97/9/2990/2536740