{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T15:53:49Z","timestamp":1759334029100,"version":"build-2065373602"},"reference-count":27,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Case Presentation: A 67-year-old man presented with transient loss of consciousness and dizziness after weeks of vomiting, weakness, and recurrent syncopal episodes. Initial laboratory findings showed hyponatremia (Na 125 mEq\/L), severe hypokalemia (K 2.3 mEq\/L), hypochloremia (Cl 77 mEq\/L), metabolic alkalemia (pH 7.5; HCO3\u2212 34 mEq\/L), low serum osmolality (263 mOsm\/L) with inappropriately concentrated urine (332 mOsm\/kg), and prerenal azotemia (creatinine 3.4 mg\/dL; eGFR 19 mL\/min\/1.73 m2; blood urea 209 mg\/dL). Contrast-enhanced CT, along with colonoscopy, identified a large mucus-secreting villous adenoma in the upper rectum. After fluid and electrolyte replacement, the patient underwent surgical resection with complete remission of symptoms and correction of electrolyte abnormalities on follow-up. Conclusion: Rectal villous adenomas should be considered in older adults with unexplained hypovolemia, hypokalemic hyponatremia, and metabolic alkalemia. Early recognition and definitive resection are curative and prevent kidney injury.<\/jats:p>","DOI":"10.3390\/diagnostics15192459","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T11:28:32Z","timestamp":1758886112000},"page":"2459","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["McKittrick\u2013Wheelock Syndrome, a Rare Cause of Nonresponsive Persistent Dyselectrolytemia"],"prefix":"10.3390","volume":"15","author":[{"given":"Daniela","family":"Cana Ruiu","sequence":"first","affiliation":[{"name":"Department of Nephrology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihaela","family":"Cheie","sequence":"additional","affiliation":[{"name":"2nd Surgical Clinic, Craiova\u2019s Emergency Hospital, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirela Marinela","family":"Florescu","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreea Doriana","family":"Stanculescu","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Popescu","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3410-1334","authenticated-orcid":false,"given":"Daniela-Teodora","family":"Maria","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian Constantin","family":"Toma","sequence":"additional","affiliation":[{"name":"General Surgery Department, Dr. Constantin Andreoiu, Ploiesti County Emergency Hospital, 100097 Ploiesti, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naomi","family":"Fota","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1523-9116","authenticated-orcid":false,"given":"Daniela","family":"Calina","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1984-791X","authenticated-orcid":false,"given":"Bogdan Silviu","family":"Ungureanu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Hureaux, M., and Vargas-Poussou, R. 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