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

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

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.