Acute pancreatitis associated with primary hyperparathyroidism |
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Authors: | Alberto Biondi Roberto Persiani Michele Marchese Ferdinando Cananzi Domenico D’Ugo |
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Institution: | Emergency and General Surgery Unit, Fondazione IRCCS Ca' Granda Policlinico Maggiore, Via F. Sforza 35, 20122 Milan, Italy. biondi.alberto@tiscali.it |
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Abstract: | Coexistence of primary hyperparathyroidism and acute pancreatitis has widely been reported in literature, but a causal relationship remains controversial. A case of acute pancreatitis as a first symptom of primary hyperparathyroidism with severe hypercalcemia is reported. In this patient a reduction of serum calcium level was obtained with medical therapy and resulted in the resolution of acute pancreatitis symptoms within 10 days. At the same time a parathyroid adenoma was clinically identified and elective parathyroidectomy was performed with complete normalization of intact parathyroid hormone and serum calcium level. At three-year follow-up, no recurrence or complications of pancreatitis were documented. The presented case suggests a cause and effect relationship between acute pancreatitis and severe hypercalcemia which should be kept in mind in the differential diagnosis of non-biliary, non-alcoholic acute pancreatitis. Reduction of hypercalcemia with medical treatment can represent a good chance for elective surgical neck exploration. |
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