Endocrine Pancreatic Islet Disease With Diarrhea

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Abstract
A 34-year-old woman with watery diarrhea and hypokalemia was cured by total pancreatectomy. Microscopic study of the pancreas showed diffuse hyperplasia of nonbeta pancreatic islet cells and ducts. Electron microscopy showed suggestive evidence of an increase in islet cells, particularly alpha cells in the acinar tissue of the pancreas removed at operation. Fifty-four additional cases of the watery diarrhea and hypokalemia syndrome associated with nonbeta pancreatic islet disease were reviewed. Early diagnosis and surgery should lead to higher cure rates. Clinical manifestations of the syndrome included watery diarrhea, hypokalemia, diabetes mellitus, hypercalcemia, gastric achlorhydria, steroid responsiveness, tetany, and flushing attacks.