Primary hyperparathyroidism presenting as acute pancreatitis: An institutional experience with review of the literature

作     者：K G Rashmi Sadishkumar Kamalanathan Jayaprakash Sahoo Dukhabandhu Naik Pazhanivel Mohan Biju Pottakkat Sitanshu Sekhar Kar Rajan Palui Ayan Roy 

作者机构：Department of EndocrinologyJIPMERPuducherry 605006India Department of Medical GastroenterologyJIPMERPuducherry 605006India Department of Surgical GastroenterologyJIPMERPuducherry 605006India Department of Preventive and Social MedicineJIPMERPuducherry 605006India 

出 版 物：《World Journal of Gastrointestinal Pharmacology and Therapeutics》 (世界胃肠药理与治疗学杂志（英文版）（电子版）)

年 卷 期：2022年第13卷第4期

页      面：47-56页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Acute pancreatitis Chronic pancreatitis Parathyroid hormone Primary hyperparathyroidism Skeletal manifestations 

摘      要：BACKGROUND Acute pancreatitis(AP)presenting as an initial manifestation of primary hyperparathyroidism(PHPT)is uncommon,and its timely diagnosis is crucial in preventing recurrent attacks of *** To determine the clinical,biochemical,and radiological profile of PHPT patients presenting as *** This is a retrospective observational study,51 consecutive patients admitted with the diagnosis of PHPT during January 2010 and October 2021 at a tertiary care hospital in Puducherry,India was *** diagnosis of AP was established in the presence of at least two of the three following features:abdominal pain,levels of serum amylase or lipase greater than three times the normal,and characteristic features at abdominal *** Out of the 51 consecutive patients with PHPT,twelve(23.52%)had pancreatitis[5(9.80%)AP,seven(13.72%)chronic pancreatitis(CP)].PHPT with AP(PHPT-AP)was more common among males with the presentation at a younger age(35.20±16.11 vs 49.23±14.80 years,P=0.05)and lower plasma intact parathyroid hormone(iPTH)levels[125(80.55-178.65)vs 519.80(149-1649.55,P=0.01)]compared to PHPT without pancreatitis(PHPT-NP).The mean serum calcium levels were similar in both PHPT-AP and PHPT-NP groups[(11.66±1.15 mg/dL)vs(12.46±1.71 mg/dL),P=0.32].PHPT-AP also presented with more gastrointestinal symptoms like abdominal pain,nausea,and vomiting with lesser skeletal and renal manifestations as compared to patients with *** AP can be the only presenting feature of *** or higher serum calcium levels during AP should always draw attention towards endocrine causes like PHPT.