Diarrhoea in a 2-year-old boy – thinking beyond the gut

• Authors: Yaryna Romanyshyn , Yarema Voznytsa , Bohdan Romanyshyn , Khrystyna Lischuk-Yakymovych

Title variants

PL

Biegunka u 2-letniego chłopca – etiologia pozajelitowa

• Languages of publication: EN

Abstracts

EN

We report a male child with an unusual, very rare cause of chronic diarrhoea – WDHA (watery diarrhoea, hypokalaemia, achlorhydria) syndrome. A 2-year-old boy presented with long-term diarrhoea, failure to thrive and a presumed diagnosis of coeliac disease. The failure of a gluten-free diet, permanent hypokalaemia and the progressive worsening of the patient’s condition led to the finding of an adrenal tumour (mature ganglioneuroma) with elevation of vasoactive intestinal polypeptide (VIP) – criteria for the diagnosis of WDHA syndrome. Complete symptoms resolution occurred after tumour excision.

PL

W niniejszej pracy opisujemy przypadek dziecka z przewlekłą biegunką o niezwykle rzadkiej etiologii, jaką jest zespół WDHA (watery diarrhoea, hypokalaemia, achlorhydria), w języku polskim częściej określany jako zespół Vernera–Morrisona. U dwuletniego chłopca występowały przewlekła biegunka oraz niedobór wzrostu i wagi, skutkując domniemanym rozpoznaniem celiakii. W wyniku dalszego postępowania diagnostycznego, wynikającego z braku efektów wprowadzonej diety bezglutenowej oraz utrzymującej się hipokaliemii przy pogarszającym się stanie pacjenta, ujawniono guza nadnerczy (dojrzały ganglioneuroma) oraz podwyższone stężenie VIP (vasoactive intestinal polypeptide, wazoaktywny peptyd jelitowy), które stanowią kryteria rozpoznania zespołu Vernera–Morrisona. Objawy ustąpiły całkowicie po chirurgicznym usunięciu guza.

Keywords

EN

VIP; WDHA; celiac disease; hypokalaemia

Discipline

• MEDICINE: MEDICINE

• Journal: Pediatria i Medycyna Rodzinna
• Year: 2018
• Volume: 14
• Issue: 2
• Pages: 237–240

Contributors

author

Yaryna Romanyshyn

• Department of Paediatrics, Western Ukrainian Specialized Children’s Medical Centre, Lviv, Ukraine,

author

Yarema Voznytsa

• Department of Paediatrics, Western Ukrainian Specialized Children’s Medical Centre, Lviv, Ukraine

author

Bohdan Romanyshyn

• Department of Surgery, Western Ukrainian Specialized Children’s Medical Centre, Lviv, Ukraine

author

Khrystyna Lischuk-Yakymovych

• Department of Clinical Immunology and Allergology, Lviv National Medical University, Lviv, Ukraine

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• Document Type: article