Primary hyperparathyroidism presenting as recurrent acute pancreatitis: A case report and review of literature

Misgar, Raiz Ahmad; Mathew, Vivek; Pandit, Kaushik; Chowdhury, Subhankar

doi:10.4103/2230-8210.77588

Cited by 26 publications

(16 citation statements)

References 8 publications

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“…PHPT can present as recurrent acute pancreatitis or chronic pancreatitis. [ 20 21 ] Previous data from India report that 12–13% patients with PHPT have pancreatitis. [ 6 7 22 ] In our series, pancreatitis was present in only 3 (4.41%) patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical and laboratory profile of primary hyperparathyroidism in Kashmir Valley: A single-center experience

Misgar

Dar

Masoodi

et al. 2016

Indian J Endocr Metab

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Background:Although primary hyperparathyroidism (PHPT) has become an asymptomatic disease in the West, in India, PHPT is still an uncommonly diagnosed, overtly symptomatic disease with skeletal, muscular, and renal manifestations.Aims:To describe the profile and surgical outcome of 78 consecutive PHPT patients over a period of two decades at a single center.Materials and Methods:All patients who underwent evaluation and surgery for PHPT from January 1996 to December 2015 were included. Evaluation included measurement of serum total calcium, inorganic phosphorus, alkaline phosphatase, intact parathyroid hormone, 25-hydroxy Vitamin D, 24 hour urinary calcium and radiological survey. Ultrasonography neck and technetium-99m sestamibi scan were used for preoperative localization.Results:A total of 78 patients were identified during the two decades of whom 29 patients were studied retrospectively and 49 patients prospectively. Mean age of patients was 44.72 ± 12.46, and male:female ratio was 1:6. The most common presenting features were nephrolithiasis and/or nephrocalcinosis (64.10%), bone pain (44.1%), abdominal pain (39%), constipation (26%), and myopathy (14.10%). Fractures were present only in 10.25%, and brown tumors in 6.41% patients. The cure rate in our series was 96.15%. The mean parathyroid gland weight was 2.05 ± 3.03 g. None of the 41 patients in whom long-term follow-up was available, had recurrence of PHPT.Conclusions:The profile of PHPT is changing with older age at presentation, and emergence of renal stone disease and decline in overt skeletal disease as common presentation. The parathyroid weight in our study resembles that reported from developed countries.

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Section: Discussionmentioning

confidence: 99%

Clinical and laboratory profile of primary hyperparathyroidism in Kashmir Valley: A single-center experience

Misgar

Dar

Masoodi

et al. 2016

Indian J Endocr Metab

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“…Como lo hicimos en nuestros pacientes, la identificación preoperatoria del adenoma paratiroideo se realiza con ultrasonido de cuello, tomografía de cuello o gammagrafía con sestamibi, esta última con la ventaja de documentar localizaciones ectópicas 7,8,11,13 . La resección del adenoma está indicada en pacientes con hiperparatiroidismo primario sintomático o en aquellos asintomáticos que cumplan uno o más de los criterios internacionales para tratamiento de pacientes con hiperparatiroidismo primario asintomático: calcio sérico mayor de 1 mg/dl sobre el límite superior normal de calcio, depuración de creatinina menor a 60 ml/min, densidad ósea en la cadera, columna o radio distal más de 2.5 desviaciones estándares por debajo de la densidad pico del hueso (T score menor 2.5), antecedente o riesgo de fractura y edad menor a 50 años 7,11 .…”

Section: Discussionunclassified

“…Los valores de paratohormona se normalizan inmediatamente con la resección del adenoma, pudiéndose corroborar en el transoperatorio. Los síntomas relacionados ceden inmediatamente de su resección 7,11,13 . La resección quirúrgica del adenoma paratiroideo normalizó los valores de calcio sérico y paratohormona en los casos presentados, ninguno de los pacientes presentó en su seguimiento nuevo cuadro de pancreatitis.…”

Section: Discussionunclassified

Pancreatitis aguda asociada con hipercalcemia

Tun-Abraham

Martínez-Ordaz

Obregón-Guerrero

et al. 2015

Cirugía y Cirujanos

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Acute pancreatitis secondary to hypercalcaemia of primary hyperparathyroidism is rare; however, when it occurs it is associated with severe pancreatitis. It is suspected in patients with elevated serum calcium and high parathyroid hormone levels. Imaging techniques such as cervical ultrasound, computed tomography, and scintigraphy using 99mTc-Sestambi, should be performed, to confirm clinical suspicion. Surgical resection is the definitive treatment with excellent results.

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“…Misgar et al reported the case of a 32-year-old man who was diagnosed to have PHTP during the fourth attack of pancreatitis. But the patient did not have any skeletal manifestations and his postoperative period was uneventful (7). PHPT can be part of MEN, types 1 and 2A.…”

Section: Discussionmentioning

confidence: 99%

Primary hyperparathyroidism presenting with acute pancreatitis and asymptomatic bone involvement

Saif¹

2015

ccmbm

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SummaryA 15-year-old female patient presented to the emergency room with vomiting and abdominal pain. She had two similar attacks in the previous three months both of them were diagnosed as pancreatitis in two different hospitals. On admission, her serum calcium and parathyroid hormone levels were very high. CT scan revealed left inferior parathyroid adenoma. Investigations to rule out possible multiple endocrine neoplasia were all negative. The patient was managed by intravenous fluids and furosemide to lower her serum calcium level. Then, left inferior parathyroidectomy was done. Postoperatively, the patient had hungry bone syndrome with severe hypocalcaemia and was managed by intravenous calcium infusion for five days in the intensive care unit. Later, she was kept on oral calcium and vitamin D supplementation. She became symptom-free and her serum calcium improved gradually.

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Primary hyperparathyroidism presenting as recurrent acute pancreatitis: A case report and review of literature

Cited by 26 publications

References 8 publications

Clinical and laboratory profile of primary hyperparathyroidism in Kashmir Valley: A single-center experience

Clinical and laboratory profile of primary hyperparathyroidism in Kashmir Valley: A single-center experience

Pancreatitis aguda asociada con hipercalcemia

Primary hyperparathyroidism presenting with acute pancreatitis and asymptomatic bone involvement

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