DOI: https://dx.doi.org/10.18203/2349-3933.ijam20220126
Published: 2022-01-25

Acute pancreatitis as first presentation of primary hyperparathyroidism: an observational study at tertiary care centre Jammu and Kashmir, India

Mohmad Saleem Chesti, Sheenam Gazala, Ali Imran

Abstract


Metabolic causes of acute pancreatitis though uncommon, are important as early recognition helps in the management and prevention of recurrent episodes. Among the uncommon etiologies, Primary hyperparathyroidism (PHPT) is one of the important causes of acute pancreatitis. We studied nine patients with acute or recurrent acute pancreatitis with etiology of PHPT. All patients had elevated serum calcium on admission and high levels of circulating parathyroid hormone. Ultrasonography, 4D CT and Sestamibi scan was used to localize parathyroid adenoma. These patients underwent parathyroidectomy and post-operative histology was consistent with parathyroid adenoma.


Keywords


Hypercalcemia, Hyperparathyroidism, Pancreatitis

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References


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Gullo L, Migliori M, Oláh A, Farkas G, Levy P, Arvanitakis C, et al. Acute pancreatitis in five European countries: etiology and mortality. Pancreas. 2002;24(3):223-7.

Lowenfels AB, Maisonneuve P, Sullivan T. The changing character of acute pancreatitis: epidemiology, etiology, and prognosis. Curr Gastroenterol Rep. 2009;11:97-103.

Johnson C, Lévy P. Detection of gallstones in acute pancreatitis: when and how? Pancreatology. 2010;10(1):27-32.

Magno MJ, Di EP. Pancreas divisum does not cause pancreatitis, but associates with CFTR mutations. Am J Gastroenterol. 2012;107:318-20.

Bai HX, Giefer M, Patel M, Orabi AI, Husain SZ. The association of primary hyperparathyroidism with pancreatitis. J Clin Gastroenterol. 2012;46:656-61.

Badalov N, Baradarian R, Iswara K. Drug induced acute pancreatitis: an evidence based approach. Clin Gastroenterol Hepatol. 2007;101:454-76.

Fortson MR, Freedman SN, Webster PD. Clinical assessment of hyperlipidemic pancreatitis. Am J Gastroenterol. 1995;90(12):2134-9.

Parenti DM, Steinberg W, Kang P. Infectious causes of acute p1. Lankisch PG, Assmus C, Lehnick D, Maisonneuve P, Lowenfels AB. Acute pancreatitis: does gender matter?. Dig Dis Sci. 2001;46(11):2470-4.

Gullo L, Migliori M, Oláh A, Farkas G, Levy P, Arvanitakis C, et al. Acute pancreatitis in five European countries: etiology and mortality. Pancreas. 2002;24(3):223-7.

Lowenfels AB, Maisonneuve P, Sullivan T. The changing character of acute pancreatitis: epidemiology, etiology, and prognosis. Curr Gastroenterol Rep. 2009;11:97-103.

Johnson C, Lévy P. Detection of gallstones in acute pancreatitis: when and how? Pancreatology. 2010;10(1):27-32.

Magno MJ, Di EP. Pancreas divisum does not cause pancreatitis, but associates with CFTR mutations. Am J Gastroenterol. 2012;107:318-20.

Bai HX, Giefer M, Patel M, Orabi AI, Husain SZ. The association of primary hyperparathyroidism with pancreatitis. J Clin Gastroenterol. 2012;46:656-61.

Badalov N, Baradarian R, Iswara K. Drug induced acute pancreatitis: an evidence based approach. Clin Gastroenterol Hepatol. 2007;101:454-76.

Fortson MR, Freedman SN, Webster PD. Clinical assessment of hyperlipidemic pancreatitis. Am J Gastroenterol. 1995;90(12):2134-9.

Parenti DM, Steinberg W, Kang P. Infectious causes of acute pancreatitis. Pancreas. 1996;13(4):356-71.

Carnaille B, Oudar C, Pattou F, Combemale F, Rocha J, Proye C. Pancreatitis and primary hyperparathyroidism: forty cases. Aust NZJ Surg. 1998;68:117-9.

Kruger B, Abrecht E, Lerch MM. The role of intracellular calcium signally in premature protease activation and on set of pancreatitis. Am J Pathol. 2000;157(1):555-8.

Ammori BJ, Barclay GR, Larvin M, McMahon MJ. Hypocalcemia in patients with acute pancreatitis: a putative role for systemic endotoxin exposure. Pancreas. 2003;26(3):213-7.

Lafferty FW. Differential diagnosis of hypercalcemia. J Bone Miner Res. 1991; 6(2):51-9.

Suliburk JW, Perrier ND. Primary hyperparathyroidism. Oncologist. 2007;12(6):644-53.

Lankisch PG, Assmus C, Lehnick D, Maisonneuve P, Lowenfels AB. Acute pancreatitis: does gender matter?. Dig Dis Sci. 2001;46(11):2470-4.

Gullo L, Migliori M, Oláh A, Farkas G, Levy P, Arvanitakis C, et al. Acute pancreatitis in five European countries: etiology and mortality. Pancreas. 2002;24(3):223-7.

Lowenfels AB, Maisonneuve P, Sullivan T. The changing character of acute pancreatitis: epidemiology, etiology, and prognosis. Curr Gastroenterol Rep. 2009;11:97-103.

Johnson C, Lévy P. Detection of gallstones in acute pancreatitis: when and how? Pancreatology. 2010;10(1):27-32.

Magno MJ, Di EP. Pancreas divisum does not cause pancreatitis, but associates with CFTR mutations. Am J Gastroenterol. 2012;107:318-20.

Bai HX, Giefer M, Patel M, Orabi AI, Husain SZ. The association of primary hyperparathyroidism with pancreatitis. J Clin Gastroenterol. 2012;46:656-61.

Badalov N, Baradarian R, Iswara K. Drug induced acute pancreatitis: an evidence based approach. Clin Gastroenterol Hepatol. 2007;101:454-76.

Fortson MR, Freedman SN, Webster PD. Clinical assessment of hyperlipidemic pancreatitis. Am J Gastroenterol. 1995;90(12):2134-9.

Parenti DM, Steinberg W, Kang P. Infectious causes of acute pancreatitis. Pancreas. 1996;13(4):356-71.

Carnaille B, Oudar C, Pattou F, Combemale F, Rocha J, Proye C. Pancreatitis and primary hyperparathyroidism: forty cases. Aust NZJ Surg. 1998;68:117-9.

Kruger B, Abrecht E, Lerch MM. The role of intracellular calcium signally in premature protease activation and on set of pancreatitis. Am J Pathol. 2000;157(1):555-8.

Ammori BJ, Barclay GR, Larvin M, McMahon MJ. Hypocalcemia in patients with acute pancreatitis: a putative role for systemic endotoxin exposure. Pancreas. 2003;26(3):213-7.

Lafferty FW. Differential diagnosis of hypercalcemia. J Bone Miner Res. 1991; 6(2):51-9.

Suliburk JW, Perrier ND. Primary hyperparathyroidism. Oncologist. 2007;12(6):644-53.

ancreatitis. Pancreas. 1996;13(4):356-71.

Car1. Lankisch PG, Assmus C, Lehnick D, Maisonneuve P, Lowenfels AB. Acute pancreatitis: does gender matter?. Dig Dis Sci. 2001;46(11):2470-4.

Gullo L, Migliori M, Oláh A, Farkas G, Levy P, Arvanitakis C, et al. Acute pancreatitis in five European countries: etiology and mortality. Pancreas. 2002;24(3):223-7.

Lowenfels AB, Maisonneuve P, Sullivan T. The changing character of acute pancreatitis: epidemiology, etiology, and prognosis. Curr Gastroenterol Rep. 2009;11:97-103.

Johnson C, Lévy P. Detection of gallstones in acute pancreatitis: when and how? Pancreatology. 2010;10(1):27-32.

Magno MJ, Di EP. Pancreas divisum does not cause pancreatitis, but associates with CFTR mutations. Am J Gastroenterol. 2012;107:318-20.

Bai HX, Giefer M, Patel M, Orabi AI, Husain SZ. The association of primary hyperparathyroidism with pancreatitis. J Clin Gastroenterol. 2012;46:656-61.

Badalov N, Baradarian R, Iswara K. Drug induced acute pancreatitis: an evidence based approach. Clin Gastroenterol Hepatol. 2007;101:454-76.

Fortson MR, Freedman SN, Webster PD. Clinical assessment of hyperlipidemic pancreatitis. Am J Gastroenterol. 1995;90(12):2134-9.

Parenti DM, Steinberg W, Kang P. Infectious causes of acute pancreatitis. Pancreas. 1996;13(4):356-71.

Carnaille B, Oudar C, Pattou F, Combemale F, Rocha J, Proye C. Pancreatitis and primary hyperparathyroidism: forty cases. Aust NZJ Surg. 1998;68:117-9.

Kruger B, Abrecht E, Lerch MM. The role of intracellular calcium signally in premature protease activation and on set of pancreatitis. Am J Pathol. 2000;157(1):555-8.

Ammori BJ, Barclay GR, Larvin M, McMahon MJ. Hypocalcemia in patients with acute pancreatitis: a putative role for systemic endotoxin exposure. Pancreas. 2003;26(3):213-7.

Lafferty FW. Differential diagnosis of hypercalcemia. J Bone Miner Res. 1991; 6(2):51-9.

Suliburk JW, Perrier ND. Primary hyperparathyroidism. Oncologist. 2007;12(6):644-53.

naille B, Oudar C, Pattou F, Combemale F, Rocha J, Proye C. Pancreatitis and primary hyperparathyroidism: forty cases. Aust NZJ Surg. 1998;68:117-9.

Kruger B, Abrecht E, Lerch MM. The role of intracellular calcium signally in premature protease activation and on set of pancreatitis. Am J Pathol. 2000;157(1):555-8.

Ammori BJ, Barclay GR, Larvin M, McMahon MJ. Hypocalcemia in patients with acute pancreatitis: a putative role for systemic endotoxin exposure. Pancreas. 2003;26(3):213-7.

Lafferty FW. Differential diagnosis of hypercalcemia. J Bone Miner Res. 1991; 6(2):51-9.

Suliburk JW, Perrier ND. Primary hyperparathyroidism. Oncologist. 2007;12(6):644-53.