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This is the association of secretory diarrhoea with intestinal tumours secreting
vasoactive intestinal peptide (VIP) - VIPoma.
The Verner-Morrison syndrome
is characterised by a profuse, watery diarrhoea that results in massive intestinal
loss of water, potassium, sodium and bicarbonate, leading to hypovolaemia, hypokalaemia
and reduced total body potassium, and achlorhydria (metabolic acidosis).
account for fewer than 10% of islet cell tumours
- mostly solitary tumours,
arising from the VIP-secreting cells that are usually located in the region of
the pancreatic tail and body
- more than 60% of these tumours are malignant
and metastasize to lymph nodes, liver, kidneys and bone
- rarely, extrapancreatic
tumours appearing as neuroblastomas, ganglioneuroblastomas or ganglioneuromas
have been found
- VIPomas rarely occur in MEN-I patients (in approximately
Associated metabolic features include:
glucose tolerance; VIP causes mild insulin resistance
- directed by a specialist
- may require an intensive
intravenous supplementation of fluid losses and a careful correction of electrolyte
and acid–base abnormalities
- octapeptide somatostatin analogues lead to
reduced tumoural VIP secretion by more than 50% and inhibit intestinal water and
- corticosteroids may also improve diarrhoea (1)
surgical removal of the primary tumour may be curative in approximately 40% of
patients with either benign VIPomas or non-metastatic malignant tumours
Herder WW and Lamberts SWJ. Best Practice & Research Clinical Endocrinology &
Metabolism 2004; Volume 18(4): 477-495.
Last reviewed 01/2018