{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:10:08Z","timestamp":1756278608127,"version":"3.44.0"},"reference-count":22,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,1,26]]},"abstract":"<jats:p>This paper details the case of a 26-year-old woman with depletion syndrome and the effectiveness of her treatment with indomethacin. Villous adenomas are benign neoplasms with a high incidence of becoming malignant. A small percentage of villous adenomas are known to cause depletion syndrome, also referred to as the McKittrick-Wheelock syndrome, a condition characterised by secretory diarrhoea, dehydration, hyponatremia, hypokalaemia, hypochloraemia, metabolic acidosis and acute renal failure. Prostaglandin-E2 mediates the hypersecretion mechanism observed in depletion syndrome, and can be inhibited by cyclo-oxygenase inhibitors. This case study measured the effectiveness of prostaglandin inhibition on a patient with oral and parenteral electrolyte replacement refractory depletion syndrome. Fluid loss and prostaglandin levels were measured before and after pharmacological treatment. This case demonstrates a 49% decrease in rectal effluent and a marked commensurate decrease in daily replenishment requirements within 48\u2005hours of indomethacin treatment initiation, resulting in subsequent electrolyte stabilisation.<\/jats:p>","DOI":"10.1136\/bcr-2016-217211","type":"journal-article","created":{"date-parts":[[2017,2,10]],"date-time":"2017-02-10T10:55:12Z","timestamp":1486724112000},"page":"bcr2016217211","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Indomethacin therapy effective in a patient with depletion syndrome from secretory villous adenoma"],"prefix":"10.1136","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1052-4874","authenticated-orcid":false,"given":"Matthew David","family":"Kagan","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Kern Medical, Bakersfield, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7563-2844","authenticated-orcid":false,"given":"Kara","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of California San Francisco Fresno Center for Medical Education and Research, Fresno, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gurtej","family":"Sangha","sequence":"additional","affiliation":[{"name":"Ross University School of Medicine, North Brunswick, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,2,10]]},"reference":[{"key":"2025082623381527000_2017.feb10_1.bcr2016217211.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199304013281301"},{"key":"2025082623381527000_2017.feb10_1.bcr2016217211.2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-916274"},{"key":"2025082623381527000_2017.feb10_1.bcr2016217211.3","first-page":"63","article-title":"McKittrick-Wheelock syndrome-a rare cause of acute renal failure","volume":"14","author":"Popescu","year":"2005","journal-title":"Rom J Gastroenterol"},{"key":"2025082623381527000_2017.feb10_1.bcr2016217211.4","doi-asserted-by":"crossref","unstructured":"McKittrick LS , Wheelock FC Jr . 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