WDHA (WATERY DIARRHEA, HYPOKALEMIA, ACHLORHYDRIA) SYNDROME - CLINICAL-FEATURES, DIAGNOSIS, AND TREATMENT

WDHA (watery diarrhea, hypokalemia, and achlorhydria) syndrome is an u nusual paraneoplastic condition caused by excess vasoactive intestinal polypeptide (VIP) secreted by certain tumors. The onset of the syndro me is insidious, and diagnosis is usually delayed by months to years. Morbidity and mortality from untreated WDHA syndrome are related to lo ng-standing dehydration and electrolyte and acid-base disturbances res ulting in chronic renal failure. Diagnosis requires documentation of l arge volumes of secretory diarrhea, elevated serum VIP levels, and loc alization of the VIP-secreting tumor. Treatment includes correction of volume, electrolyte, and metabolic abnormalities, pharmacotherapy to decrease gastrointestinal secretion and increase absorption, and ultim ately surgical resection or debulking of the vipoma.