Indomethacin-Responsive Pancreatic Cholera

Abstract

Pancreatic cholera, otherwise known as the Verner-Morrison¹ syndrome or the syndrome of watery diarrhea, hypokalemia and achlorhydria,² is a rare clinical entity caused by non-β islet-cell tumors. The clinical characteristics, recently reviewed in detail,^{3 4 5} routinely include profuse watery diarrhea, hypokalemia, metabolic acidosis and gastric hyposecretion of acid and pepsin. Other frequent findings include hypercalcemia, glucose intolerance and flushing. Although elevations in plasma and tumor levels of vasoactive intestinal polypeptide and human pancreatic polypeptide have been reported,^{6 7 8 9 10} neither of these peptides has been firmly implicated as the diarrheagenic hormone. We have previously described elevations in plasma levels of prostaglandin E in . . .