Next, we have another type of pancreatic Islet
cell tumor, but this time it is vasoactive
So, now, the pancreas and a tumor of it is
now producing a VIP, oh, VIP, too much VIP.
With all this VIP, now the physiology behind
this, if you remember, VIP physiologically
down in the intestine is actually going to
increase the secretion of chloride and water
into the lumen of your intestine.
If you do this excessively, the WD acronym,
you put that together gives you extreme water
With all of this diarrhea that is being flushed
out, you are worried about potassium being
lost as well.
So, therefore, severe significant hypokalemia.
Look for your potassium levels.
Now, 3.5 to 5.0 is normal, ml equivalence.
If you find your potassium levels to be a,
let’s say 1.5, along with water diarrhea
and all part of MEN 1, you should be thinking
about a vasoactive intestinal peptide-oma
and A is achlorhydria.
A couple of differentials that you should
be thinking about with achlorhydria, what
does that mean?
That means that the gastric lumen inside the
gastric in the stomach, you should not be
putting your fingers in there because you
won’t have a finger left when you take it
back out because the acid will get rid of
So, achlorhydria means no acid.
So, your gastric luminal pH will be elevated,
it is not acidic.
Now, a couple of differentials with achlorhydria
in addition include pernicious anemia, also
something called Plummer-Vinson syndrome,
All of those may result in achlorhydria.
WDHA is what your focus should be on, VIPoma,
where are you in the body?
The pancreas, could all be part of MEN 1.