Kibria Rizwan, Ahmed Sameer, Ali Syed A, Barde Christopher J
Department of Gastroenterology, Wright State University School of Medicine, Dayton, OH 45428, USA.
South Med J. 2009 Jul;102(7):761-4. doi: 10.1097/SMJ.0b013e3181a5cead.
Mild hypokalemia is common and encountered in a multitude of diseases, but severe hypokalemia leading to rhabdomyolysis is relatively rare. The watery diarrhea, hypokalemia, achlorhydria (WDHA) syndrome caused by vasoactive intestinal polypeptide (VIP)-producing tumors, is an extremely rare cause of hypokalemic rhabdomyolysis and the literature is limited to one case report. We report a second case of an adult who presented with rhabdomyolysis due to severe hypokalemia. Further evaluation revealed that he had a VIP-producing pancreatic neuroendocrine tumor (NET), which was the cause of his hypokalemic rhabdomyolysis. Although rare in occurrence, a high index of suspicion is of paramount importance for establishing the correct diagnosis and treatment.
轻度低钾血症很常见,在多种疾病中都会出现,但导致横纹肌溶解的严重低钾血症相对少见。由产生血管活性肠肽(VIP)的肿瘤引起的水样腹泻、低钾血症、无胃酸(WDHA)综合征,是低钾性横纹肌溶解极其罕见的病因,相关文献仅限于一篇病例报告。我们报告第二例因严重低钾血症导致横纹肌溶解的成人病例。进一步检查发现他患有产生VIP的胰腺神经内分泌肿瘤(NET),这是其低钾性横纹肌溶解的病因。尽管发病率很低,但高度的怀疑指数对于确立正确的诊断和治疗至关重要。