Elizabeth L. Frank

At a Glance Acute tubular necrosis (ATN) refers to acute kidney injury as a result of severe tubular damage. Ischemia and exposure to nephrotoxins are the primary causes of ATN. Ischemic damage is due to prolonged hypoperfusion characterized by inadequate glomerular filtration rate (GFR) and poor parenchymal cell function. Hypovolemia, septic shock, and major surgery…

At a Glance Vipoma (Verner-Morrison syndrome, pancreatic cholera, WDHA syndrome – for watery diarrhea, hypokalemia, and achlorhydria) is one of several rare types of functioning pancreatic neuroendocrine tumors (NETs) and accounts for 2-4% of all pancreatic NETs. Most cases are sporadic, but about 10% are associated with multiple endocrine neoplasia type 1 (MEN1). Vipomas are…

At a Glance Carcinoids are rare, slowly growing subtypes of neuroendocrine tumors (NETs). They arise most commonly within the gastrointestinal (65% of cases) or respiratory (35% of cases) systems and are characterized by serotonin (5-hydroxytryptamine) production. The carcinoid syndrome occurs in about 10% of carcinoid tumors (usually in the presence of metastatic disease to the…

At a Glance Clinical manifestations of Zollinger-Ellison syndrome (ZES), a syndrome caused by a gastrin-secreting neuroendocrine tumor (gastrinoma), result from high gastric acid output due to hypertrophy of parietal and histamine-secreting enterochromaffin-like (ECL) cells, as well as direct stimulation of parietal cells. More than 90% of patients develop peptic ulcers, but only a small number…

At a Glance Glucagonoma (“sweet” syndrome) is one of the functioning pancreatic neuroendocrine tumors (NETs) that account for 1-3% of all pancreatic NETs. Most cases are sporadic, but 5-17% are associated with multiple endocrine neoplasia type 1 (MEN1). Glucagonomas are typically single, large tumors (average size 6 cm) and are found almost exclusively in the…

At a Glance Insulinomas are the most common functioning pancreatic neuroendocrine tumors (NETs) and account for 20-30% of all pancreatic NETs. Most cases are sporadic, but about 5-10% are associated with multiple endocrine neoplasia type 1 (MEN1). The tumors are usually solitary (except in patients with MEN1), small (<1 cm), and almost exclusively intrapancreatic. In…