Acute Pancreatitis as a Manifestation of Primary Hyperparathyroidism: An Uncommon Association

  • Abinaya Karthikeyan Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India
  • S Siddarth Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India
  • Anantha Ramakrishnan Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India
  • Vijayashree Raghavan Chettinad Hospital andResearch Institute, Chennai, Tamil Nadu, India
  • Rajesh Kanna Chettinad Hospital andResearch Institute, Chennai, Tamil Nadu, India
Keywords: Acute or chronic pancreatitis, Hypercalcemia, Parathyroid adenoma, Primary hyperparathyroidism

Abstract

The manifestation of primary hyperparathyroidism (PHPT) as acute pancreatitis (AP) is a rare entity. We report a case of a
55-year-old female, admitted to the intensive care unit of the general surgery department presenting with features of acute
abdomen with a clinical and radiological diagnosis of AP. Further evaluation revealed hypercalcemia and PHPT due to
parathyroid adenoma. Hypercalcemia due to PHPT plays a vital role in the pathogenesis of pancreatitis. The patient underwent
parathyroidectomy and pathological examination of the parathyroid gland confirmed a parathyroid adenoma. After aggressive
medical management of AP and hypercalcemia, parathyroidectomy has been shown to improve clinical outcomes and prevent
further recurrences of pancreatitis.

Author Biographies

Abinaya Karthikeyan, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India

Junior Resident, Department of General Surgery,

S Siddarth, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India

Senior Resident, Department of General Surgery

Anantha Ramakrishnan, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India

Professor, Department of General Surgery,

Vijayashree Raghavan, Chettinad Hospital andResearch Institute, Chennai, Tamil Nadu, India

Professor, Department of Pathology

Rajesh Kanna, Chettinad Hospital andResearch Institute, Chennai, Tamil Nadu, India

Professor, Department of Pathology

References

1. Sakorafas GH, Tsiotou AG. Etiology and pathogenesis of acute pancreatitis:
Current concepts. J Clin Gastroenterol 2000;30:343-56.
2. Felderbauer P, Karakas E, Fendrich V, Bulut K, Horn T, Lebert R, et al.
Pancreatitis risk in primary hyperparathyroidism: Relation to mutations in
the SPINK1 trypsin inhibitor (N34S) and the cystic fibrosis gene. Am J
Gastroenterol 2008;103:368-74.
3. Ranson JH. Etiological and prognostic factors in human acute pancreatitis:
A review. Am J Gastroenterol 1982;77:633-8.
Published
2021-10-01