Acute Pancreatitis in a Case of Multiple Myeloma with Hypercalcemia

Lee, Kyoo Hyung; Lee, Jung Shin; Kim, Sang Hee

doi:10.3904/kjim.1989.4.2.178

Cited by 7 publications

(6 citation statements)

References 11 publications

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“…This presentation was similar to the cases reported in literature previously, where pancreatitis was the first clinical manifestation, and later on multiple myeloma was detected. Pancreatitis has been rarely reported in association with multiple myeloma, and in most of the cases, the cited reason was hypercalcemia [2,3], initiation of chemotherapy [4,5], or direct infiltration of pancreas by plasma cells [6,7]. Multiple myeloma is usually associated with hypercalcemia and incidence of hypercalcemia is about 30% in cases of multiple myeloma [8].…”

Section: Discussionmentioning

confidence: 99%

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Multiple Myeloma Presenting With Acute Pancreatitis and Renal Failure

Mishra

Patil²,

Bansal³

et al. 2017

IJCR

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Multiple myeloma is the disease of elderly male with medullary and extramedullary involvement. Pancreatitis is rarely reported in such cases. Here, we report a case of an elderly male who presented with a clinical picture of acute pancreatitis and when investigated, was found to have multiple myeloma and acute renal failure. He was further evaluated for various causes of pancreatitis and was finally concluded to have a possibility of a direct invasion of pancreas by plasma cells.

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Section: Discussionmentioning

confidence: 99%

“…ccording to the literature available, very few cases of pancreatitis in association multiple myeloma have been reported [1][2][3][4][5]. The most common cause being hypercalcemia induced pancreatitis and incidence of hypercalcemia is about (30%) in cases of multiple myeloma.…”

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confidence: 99%

Multiple Myeloma Presenting With Acute Pancreatitis and Renal Failure

Mishra

Patil²,

Bansal³

et al. 2017

IJCR

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“…In clinical pancreatitis associated with gallstones or alcoholism, the serum cal-cium concentration is normal or reduced, and most patients with hyperparathyroidism diagnosed at an early stage do not develop pancreatitis. 137 By contrast, severe hypercalcemia (whether due to multiple myeloma, 138 vitamin D intoxication, 139 or hyperparathyroidism) 140 does cause acute pancreatitis, although the mechanism is uncertain. Autoactivation of trypsinogen is unlikely; it is a slow in vitro process that takes hours, and the high content of natural trypsin inhibitor would neutralize slow activation in vivo.…”

Section: Role Of Intra-acinar Calcium Ionsmentioning

confidence: 99%

Neurological Damage and Duodenopancreatic Reflux in the Pathogenesis of Alcoholic Pancreatitis

McCutcheon

2000

Arch Surg

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To present a new theory on the pathogenesis of acute alcoholic pancreatitis based on experimental data, the significance of which has not been recognized, and on evidence from the current literature.Hypothesis: That chronic alcoholism damages muscarinic receptors in the pancreas, duodenum, and Oddi sphincter, producing heightened sensitivity to acetylcholine, stimulation of protein-rich pancreatic juice, hypertonicity of the duodenum and esophagus, relaxation of the Oddi sphincter, and intraduodenal pressures exceeding those shown to cause duodenopancreatic reflux and acute pancreatitis in humans and experimental animals.Outcome: The duodenopancreatic reflux mechanism can explain all of the clinical features of acute alcohol pan-creatitis, including the intraductal site and rapid activation of zymogens by enterokinase, the recurrent episodes of pancreatitis, the precipitation of protein plugs by partial proteolytic hydrolysis, the severe vascular changes, the relation to infection by the most direct route, and the progression to chronic pancreatitis via the necrosis-fibrosis sequence.Conclusions: Damage to the nervous system, with a time lag of 5 to 15 years between the onset of heavy drinking and the development of neurological disorders (peripheral neuropathy and cerebellar degeneration), is a characteristic complication of chronic alcoholism. The similarity to events in alcoholic pancreatitis is striking.

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“…Hypercalcemia-induced AP in MM is a rare entity, with two cases reported in the literature [4, 5]. Taking into account that glucocorticoids could cause or complicate AP, we initially tried conventional modalities for hypercalcemia and renal failure.…”

Section: Introductionmentioning

confidence: 99%