PMID- 24251163
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20131119
LR  - 20211021
IS  - 2230-8210 (Print)
IS  - 2230-9500 (Electronic)
IS  - 2230-9500 (Linking)
VI  - 17
IP  - Suppl 1
DP  - 2013 Oct
TI  - Ischemic stroke as a presenting feature of VIPoma due to MEN 1 syndrome.
PG  - S215-8
LID - 10.4103/2230-8210.119576 [doi]
AB  - INTRODUCTION: Presentation of the ischemic stroke due to vasoactive intestinal 
      peptide producing tumor (VIPoma) or Verner Morrison syndrome is rare. This is 
      first of its kind case which we are reporting here which was later turned out to 
      be multiple endocrine neoplasia type 1 (MEN 1) syndrome with diagnosis of primary 
      hyperparathyroidism in the same patient in follow-up. DESCRIPTION OF THE CASE: A 
      13-year-old girl presented to our emergency department with features of 
      disorientation, weakness of left sided extremities. She had watery high volume 
      diarrhea and related dehydration with renal failure. Blood chemistry was 
      suggestive of hypokalemia with metabolic acidosis. Patient had flushing on her 
      face during this episode of illness. Magnetic resonance imaging (MRI) of brain 
      suggested venous infarct. Computed tomography (CT) scan of abdomen done with high 
      index of suspicion was suggestive of mass in tail of pancreas mostly a VIPoma. 
      Patient was operated for the tumor after which there was no recurrence of 
      diarrhea. Biopsy of tumor was consistent with VIPoma with chomogranin A 
      positivity. Patient improved of her stroke episode with time. On follow-up she is 
      diagnosed to have primary hyperparathyroidism with hypercalcemia due to left 
      inferior parathyroid adenoma which improved with intravenous (IV) zolindronic 
      acid therapy and now she is planned to undergo parathyroidectomy. CONCLUSION: 
      VIPoma is a rare tumor but is well-described with MEN 1. Stroke as a presenting 
      feature of VIPoma is first reported with this case.
FAU - Maheshwari, Rushikesh Raviraj
AU  - Maheshwari RR
AD  - Department of Endocrinology and Metabolism, Narayana Medical College and 
      Hospital, Nellore, Andhra Pradesh, India.
FAU - Desai, Madhav
AU  - Desai M
FAU - Rao, Vara Prasada G
AU  - Rao VP
FAU - Palanki, Radha Rani
AU  - Palanki RR
FAU - Namburi, Rajendra Prasad
AU  - Namburi RP
FAU - Reddy, Karthik T S
AU  - Reddy KT
FAU - Reddy, Amaresh P
AU  - Reddy AP
LA  - eng
PT  - Journal Article
PL  - India
TA  - Indian J Endocrinol Metab
JT  - Indian journal of endocrinology and metabolism
JID - 101555690
PMC - PMC3830309
OTO - NOTNLM
OT  - Multiple endocrine neoplasia type 1
OT  - VIPoma
OT  - primary hyperparathyroidism
OT  - stroke
COIS- Conflict of Interest: None declared
EDAT- 2013/11/20 06:00
MHDA- 2013/11/20 06:01
PMCR- 2013/10/01
CRDT- 2013/11/20 06:00
PHST- 2013/11/20 06:00 [entrez]
PHST- 2013/11/20 06:00 [pubmed]
PHST- 2013/11/20 06:01 [medline]
PHST- 2013/10/01 00:00 [pmc-release]
AID - IJEM-17-215 [pii]
AID - 10.4103/2230-8210.119576 [doi]
PST - ppublish
SO  - Indian J Endocrinol Metab. 2013 Oct;17(Suppl 1):S215-8. doi: 
      10.4103/2230-8210.119576.