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Horm Metab Res 2021; 53(06): 377-381
DOI: 10.1055/a-1495-5573
Endocrine Care

Primary Hyperparathyroidism Masquerading as Acute Pancreatitis

Saurabh Arora
1   Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, Punjab, India
,
Parminder Singh
1   Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, Punjab, India
,
Rohit Verma
1   Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, Punjab, India
,
Naveen Mittal
1   Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, Punjab, India
,
Ajit Sood
1   Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, Punjab, India
,
Sanjay Kalra
1   Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, Punjab, India
,
Dhananjaya Shanthaiah
1   Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, Punjab, India
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Abstract

Acute pancreatitis as an initial manifestation of primary hyperparathyroidism (PHPT) is a rare occurrence and timely diagnosis of PHPT is crucial in preventing repeat attack of pancreatitis. The study aimed at evaluating the clinico-radiological profile of patients admitted with acute pancreatitis as the index presentation of PHPT and to determine the factors associated with development of severe pancreatitis. This series included retrospective analysis of medical records of 30 patients admitted with acute pancreatitis as initial manifestation of PHPT. Additionally, we analyzed the data of another 30 patients admitted with PHPT but without any evidence of pancreatitis, to serve as control group. The mean age of the subjects was 44.9±13.9 years with male to female ratio of 1.30. The mean serum calcium level was 12.24±2.79 mg/dl and five (16.6%) patients had normocalcemia at time of presentation. Presence of nephrolithiasis was significantly associated with severe pancreatitis. One patient had refractory hypercalcemia associated with renal failure and was successfully managed with denosumab. Patients with PHPT associated with acute pancreatitis had significantly higher calcium levels and lower frequency of skeletal involvement as compared to PHPT patients without pancreatitis. PHPT masquerading as acute pancreatitis is rare and high index of suspicion is required to diagnose this condition especially in the presence of normocalcemia at presentation. Patients with PHPT associated pancreatitis had male preponderance, higher calcium levels, and lower frequency of skeletal involvement as compared to PHPT patients without pancreatitis.

Key words

hyperparathyroidism - acute pancreatitis - hemodialysis - nephrolithiasis - refractory hypercalcemia


Publication History

Received: 24 January 2021

Accepted after revision: 26 April 2021

Article published online:
21 June 2021

© 2021. Thieme. All rights reserved.

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