Islet cell tumor of the pancreas with reversible watery diarrhea and achylorhydraia.

Summary A case of a metastasizing non-β-islet cell tumor of the pancreas with intractable watery diarrhea, hypokalemic acidosis, hypercalcemia, and alchlorhydria (WDHA syndrome) is presented. Resection of the primary tumor induced a transient partial remission of the diarrhea and a return of acid secretion, and steroid therapy given during a subsequent relapse resulted in a dramatic cessation of the diarrhea and a striking increase in acid secretion. Possible factors responsible for the achlorhydria or hypochlorhydria in patients with this syndrome are discussed, and the cause of the steroid-induced marked acid hypersecretion considered. The literature is briefly reviewed and the effect of steroids in similar cases noted. The relationship between the WDHA syndrome and the classical Zollinger-Ellison syndrome is discussed.