Syndroom van McKittrick-Wheelock

Background

The McKittrick-Wheelock syndrome is rare and is characterized by hypersecretion of fluids and electrolytes by a large rectal villous adenoma. Untreated disease may cause fatal renal failure or arrhythmia. We present 2 cases with different symptoms.

Case descriptions

An 83-year-old female with long-standing renal failure of unknown origin was admitted due to dehydration with recurrent collapse and electrolyte imbalance. Colonoscopy was performed because of persistent diarrhoea, which revealed an extensive rectal adenoma. After endoscopic mucosal resection, electrolyte values normalized entirely. A 66-year-old male presented with malaise, weight loss and severe renal failure. A giant rectal adenoma was found. After endoscopic mucosal resection, the electrolyte imbalance disappeared and renal function normalized. A fibrotic remnant required surgical removal and revealed submucosally invasive carcinoma.

Conclusion

In rare cases, renal failure and electrolyte imbalance may be caused by large rectal adenomas.

Conflict of interest and financial support: a disclosure form provided by the author is available along with the full text of this article at www.ntvg.nl; search for A5567, click on ‘Belangenverstrengeling’ (‘Conflict of interest’).