From the Guidelines
VIPomas are characterized by a syndrome of severe watery diarrhea, hypokalemia, and achlorhydria, and the primary treatment involves rehydration and somatostatin analogues, such as octreotide, to control symptoms. The symptoms of VIPomas, also known as WDHA syndrome or Werner-Morrison syndrome, include profuse diarrhea, often exceeding 3 liters per day, leading to dehydration and electrolyte imbalances 1. Patients may experience abdominal pain, nausea, vomiting, facial flushing, and weight loss, as well as metabolic acidosis, hypercalcemia, and hyperglycemia. The severe potassium depletion can cause muscle weakness, fatigue, and cardiac arrhythmias.
Key Symptoms
- Severe watery diarrhea
- Hypokalemia
- Achlorhydria
- Abdominal pain
- Nausea and vomiting
- Facial flushing
- Weight loss
- Metabolic acidosis
- Hypercalcemia
- Hyperglycemia
- Muscle weakness
- Fatigue
- Cardiac arrhythmias The tumor, usually located in the pancreas, continuously releases VIP, causing persistent symptoms that don't respond to conventional antidiarrheal medications. According to the guidelines for the management of gastroenteropancreatic neuroendocrine tumours, rehydration is always indicated and may improve the clinical condition considerably, and patients with this rare life-threatening syndrome frequently respond dramatically to small doses of somatostatin analogues with cessation of diarrhoea 1.
Treatment Approach
- Rehydration to correct fluid and electrolyte imbalances
- Somatostatin analogues, such as octreotide, to control symptoms
- Titration of the drug dose against vasoactive intestinal peptide levels, with normalization of levels being the target 1
From the FDA Drug Label
Octreotide acetate injection is indicated for the treatment of the profuse watery diarrhea associated with VIP-secreting tumors. The symptoms of VIPomas include profuse watery diarrhea.
- The main symptom is diarrhea, which can be severe and watery.
- Octreotide acetate injection is used to treat this symptom in patients with VIPomas 2. The dosage for VIPomas is typically 200 to 300 mcg in 2 to 4 divided doses per day, with a range of 150 to 750 mcg 2.
From the Research
Vipoma Symptoms
The symptoms of Vipoma, a rare neuroendocrine tumor, are characterized by:
- Watery diarrhea 3, 4, 5
- Hypokalemia (low potassium levels) 3, 4, 5
- Achlorhydria (reduced stomach acid) 3
- Dehydration 4, 5
- Muscle weakness 4
- Metabolic acidosis 5
- Hypophosphatemia (low phosphate levels) 5
- Renal impairment 5
Diagnosis and Treatment
Vipoma is diagnosed by the presence of these symptoms, laboratory analysis of blood and stool, radiological imaging, and immunohistochemical findings 3. Treatment options include: