Primary hyperparathyroidism presenting with acute pancreatitis, complicated by raised IgG-4 and positive Covid-19 IgG antibody

Hussain, Taimoor; Hafizyar, Farukhzad; Latif, Abdul; Mujadidi, M. S.; Walizada, Khalida; Mushtaq, Zahra; Kumar, Jasvindar

doi:10.1016/j.jecr.2021.100086

Cited by 2 publications

(3 citation statements)

References 17 publications

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“…Primary hyperparathyroidism with elevated serum PTH levels were found in 5 cases 12–14,16,17 . Among them, 2 patients 13,14 were found to have parathyroid adenomas on imaging and pathological specimens, while the other 2 patients 12,16 had normal parathyroid imaging examinations, and the 5th patient 17 did not have parathyroid imaging examinations.…”

Section: Discussionmentioning

confidence: 99%

“…7,10 Hypercalcemia occurring in patients with IgG4-RD is not common. A literature review showed that only 5 definitely [11][12][13][14][15] (including 1 conference abstract 15 ) and 2 possible (not biopsied) IgG4-RD 16,17 associated hypercalcemia had been reported (Table 1). According to the literature, the pathogenesis of IgG4-RD-associated hypercalcemia can be divided into parathyroid hormone (PTH)-related and non-PTH-related.…”

Section: Discussionmentioning

confidence: 99%

“…Primary hyperparathyroidism with elevated serum PTH levels were found in 5 cases. [12][13][14]16,17 Among them, 2 patients 13,14 were found to have parathyroid adenomas on imaging and pathological specimens, while the other 2 patients 12,16 had normal parathyroid imaging examinations, and the 5th patient 17 did not have parathyroid imaging examinations. Jung et al 13 reported a 57-year-old man was incidentally found with a well-demarcated mass in the left thyroid, and histopathological and immunohistochemical (IHC) findings led to the diagnosis of parathyroid adenoma with prominent lymphocytic infiltrate having features consistent with the diagnosis of IgG4-RD, which suggested IgG4-RD-related isolated parathyroid involvement.…”

Section: Pth-related Hypercalcemia In Igg4-rdmentioning

confidence: 99%

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IgG4‐related disease presenting as severely symptomatic hypercalcemia: A case report and review of literature

2023

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Immunoglobulin G4‐related disease (IgG4‐RD)‐associated hypercalcemia has rarely been reported. We report a case of IgG4‐RD that presented as severe symptomatic hypercalcemia. A 50‐year‐old woman with a history of sustained bilateral periorbital swelling and proptosis for more than 5 years presented to our hospital complaining of a 3‐day history of significant and progressive nausea, vomiting, loss of appetite, fatigue, and pruritus. She denied a long history of medication. On admission, laboratory tests showed severe hypercalcemia with serum adjusted calcium elevated to 4.34 mmol/L and renal dysfunction with serum creatinine elevated to 206 μmol/L. Urinary calcium excretion was increased. The serum IgG4 subclass was markedly elevated to 22.4 g/L with polyclonal hypergammaglobulinemia. Tests of autoantibodies were all negative. Bone metabolism markers that reflect the activity of osteoblasts and osteoclasts were all significantly elevated. However, the levels of intact parathyroid hormone and 25(OH) vitamin D3 were decreased. B‐ultrasonography showed chronic inflammation of bilateral submandibular glands. Neither bone marrow biopsy nor positron emission tomography – computed tomography examination showed evidence of neoplastic diseases. The patient was treated with intravenous saline infusion, loop diuretics, salmon calcitonin, glucocorticoids, and hemodialysis with a good response.

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