Clinical, Biochemical, and Kidney Abnormalities in McKittrick–Wheelock Syndrome: An Individual-Patient Systematic Review of Published Cases
7 affiliations
- 1Family Medicine Institute, Faculty of Biomedical Sciences, Università della Svizzera Italiana, s6900 Lugano, Switzerland
- 2Division of Pediatric Nephrology, Department of Pediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, 1205 Geneva, Switzerland
- 3Department of Anesthesia, Hôpital du Valais, 1951 Sion, Switzerland
- 4Pediatric Cardiology Unit, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital, and University of Lausanne, 1011 Lausanne, Switzerland
- 5Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, Italy
- 6Pediatric Unit, Annunziata Hospital, 87100 Cosenza, Italy
- 7Department of Surgery, Ospedale Regionale di Bellinzona e Valli, EOC, 6500 Bellinzona, Switzerland
Abstract
Background/Objectives: McKittrick–Wheelock syndrome is a rare entity secondary to colorectal tumors, characterized by chronic diarrhea, electrolyte and acid–base disturbances, and impaired kidney function; its pathophysiology and biochemical spectrum remain incompletely defined. Methods: We conducted an individual-patient systematic review of published cases (PROSPERO CRD420251233022). Eligible patients had a colorectal tumor, chronic diarrhea, and at least one otherwise unexplained electrolyte or acid–base disturbance. Data on demographics, presentation, tumor characteristics, electrolyte and acid–base abnormalities, creatinine levels, and mechanisms of diarrhea were extracted and analyzed. Results: Among 195 reports including 231 patients, median age was 68 years and symptoms usually persisted >12 months. Tumors were predominantly large distal colorectal adenomas: 97% were within 29 cm and 68% within 10 cm of the anal verge; none measured ≤50 mm and 78% measured ≥100 mm. Hypokalemia occurred in 90%, hyponatremia in 91%, metabolic acidosis in 50%, metabolic alkalosis in 28%, and elevated creatinine in 91%. Stool osmotic-gap data in eight patients and reduced stool losses with non-steroidal anti-inflammatory drugs in seven cases were compatible with secretory, partly prostaglandin-mediated diarrhea. No statistically significant, biochemical differences were detected by tumor size. Conclusions: McKittrick–Wheelock syndrome is a recognizable, potentially treatable syndrome associated with chronic diarrhea and major metabolic and kidney abnormalities, requiring early recognition.
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BibTeX
@article{lepori2026clinical,
title = {{Clinical, Biochemical, and Kidney Abnormalities in McKittrick–Wheelock Syndrome: An Individual-Patient Systematic Review of Published Cases}},
author = {Matilde Lepori and Virginia Turner and Massimiliano Bertacchi and Mario G. Bianchetti and Pietro Camozzi and Sebastiano A. G. Lava and Martin Scoglio and Gregorio P. Milani and Johannes M. A. Toti and Lisa Ponti},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15218374},
url = {https://www.mdpi.com/2077-0383/15/21/8374},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Clinical, Biochemical, and Kidney Abnormalities in McKittrick–Wheelock Syndrome: An Individual-Patient Systematic Review of Published Cases
AU - Matilde Lepori
AU - Virginia Turner
AU - Massimiliano Bertacchi
AU - Mario G. Bianchetti
AU - Pietro Camozzi
AU - Sebastiano A. G. Lava
AU - Martin Scoglio
AU - Gregorio P. Milani
AU - Johannes M. A. Toti
AU - Lisa Ponti
PY - 2026
DA - 2026/10/27
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218374
UR - https://www.mdpi.com/2077-0383/15/21/8374
AB - Background/Objectives: McKittrick–Wheelock syndrome is a rare entity secondary to colorectal tumors, characterized by chronic diarrhea, electrolyte and acid–base disturbances, and impaired kidney function; its pathophysiology and biochemical spectrum remain incompletely defined. Methods: We conducted an individual-patient systematic review of published cases (PROSPERO CRD420251233022). Eligible patients had a colorectal tumor, chronic diarrhea, and at least one otherwise unexplained electrolyte or acid–base disturbance. Data on demographics, presentation, tumor characteristics, electrolyte and acid–base abnormalities, creatinine levels, and mechanisms of diarrhea were extracted and analyzed. Results: Among 195 reports including 231 patients, median age was 68 years and symptoms usually persisted >12 months. Tumors were predominantly large distal colorectal adenomas: 97% were within 29 cm and 68% within 10 cm of the anal verge; none measured ≤50 mm and 78% measured ≥100 mm. Hypokalemia occurred in 90%, hyponatremia in 91%, metabolic acidosis in 50%, metabolic alkalosis in 28%, and elevated creatinine in 91%. Stool osmotic-gap data in eight patients and reduced stool losses with non-steroidal anti-inflammatory drugs in seven cases were compatible with secretory, partly prostaglandin-mediated diarrhea. No statistically significant, biochemical differences were detected by tumor size. Conclusions: McKittrick–Wheelock syndrome is a recognizable, potentially treatable syndrome associated with chronic diarrhea and major metabolic and kidney abnormalities, requiring early recognition.
SN - 2077-0383
ER -