Acute Pancreatitis Associated with Hypercalcemia as the Initial Presentation of Primary Hyperparathyroidism

Pancreatite Aguda Associada a Hipercalcemia como Forma de Apresentação de Hiperparatiroidismo Primário

Authors

  • Ana Órfão Serviço de Medicina 3, Unidade Local de Saúde Amadora/Sinta, Amadora, Portugal
  • Ana Carolina Monteiro Serviço de Medicina 3, Unidade Local de Saúde Amadora/Sinta, Amadora, Portugal
  • Garcieth Gomes Serviço de Medicina 3, Unidade Local de Saúde Amadora/Sinta, Amadora, Portugal
  • João Pedro Santos Intensive Care Medicine, Unidade Local de Saúde Amadora/Sinta, Amadora, Portugal
  • Miguel Monteiro Serviço de Medicina 3, Unidade Local de Saúde Amadora/Sinta, Amadora, Portugal
  • Clara Matos Serviço de Medicina 3, Unidade Local de Saúde Amadora/Sinta, Amadora, Portugal

DOI:

https://doi.org/10.60591/crspmi.179

Keywords:

Hypercalcemia, Hyperparathyroidism, Primary/complications, Pancreatitis/etiology

Abstract

Hypercalcemia due to primary hyperparathyroidism is a
rare cause of acute pancreatitis.

We present the case of an 81-year-old woman, who was
admitted for acute pancreatitis, in the absence of the most
common risk factors. Since the total calcium was slightly increased, and hypocalcemia is expected in acute pancreatitis, the hypothesis of primary hyperparathyroidism was suspected. Low serum phosphorus and elevated parathyroid hormone were also consistent with primary hyperparathyroidism, and the diagnosis was confirmed with parathyroid scintigraphy
showing hyperfunctioning parathyroid tissue in the lower
right thyroid pole. The patient was discharged awaiting to
perform renal ultrasound and osteodensitometry to assess
the presence of nephrolithiasis and osteoporosis, respectively, to evaluate the indication for parathyroidectomy.

This case highlights the importance of early identification
of primary hyperparathyroidism as a possible cause of pancreatitis to promptly start the proper intervention, preventing further episodes of pancreatitis and decreasing the likelihood of complications of primary hyperparathyroidism.

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References

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Mehta G, Rathod VM, Patel T, Solanki D. Atypical Presentation of Primary Hyperparathyroidism as Recurrent Pancreatitis: A Case Report With a Review of the Literature. Cureus. 15:41140. doi: 10.7759/cureus.41140

Abdominal and pelvic CT with contrast showed a pancreas with an enlarged cephalic portion (yellow arrow) with irregular contrast distribution and moderate densification of peripancreatic fat (blue arrow) and thickening of the renal fascia bilaterally.

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Published

26-09-2024

How to Cite

Órfão, A., Monteiro, A. C., Gomes, G., Santos, J. P., Monteiro, M., & Matos, C. (2024). Acute Pancreatitis Associated with Hypercalcemia as the Initial Presentation of Primary Hyperparathyroidism: Pancreatite Aguda Associada a Hipercalcemia como Forma de Apresentação de Hiperparatiroidismo Primário. SPMI Case Reports, 2(3), 97–102. https://doi.org/10.60591/crspmi.179