Sandeep Thareja1, Manish Manrai2, Rajat Shukla3, Atul Kumar Sood4, Atul Jha5, A K Tyagi6, Vimal Upreti7, G P S Gahlot8, Sachin Maggo9. 1. Consultant (Medicine) & Gastroenterologist, Base Hospital, Delhi Cantt, India. 2. Associate Professor, Department of Internal Medicine, Armed Forces Medical College, Pune 411040, India. 3. Senior Advisor (Medicine & Gastroenterology), Command Hospital (Western Command), Chandigarh, India. 4. Commandant, Military Hospital Dehradun, India. 5. Classified Specialist (Medicine) & Gastroenterologist, Army Hospital (R&R), New Delhi, India. 6. Professor & Head, Department of Surgery, Armed Forces Medical College, Pune 411040, India. 7. Senior Advisor (Medicine) & Endocrinologist, 151 Base Hospital, C/o 99 APO, India. 8. Classified Specialist (Pathology) & Oncopathologist, Army Hospital (R&R), New Delhi, India. 9. Graded Specialist (Medicine), 2009 Field Hospital, C/o 56 APO, India.
Abstract
BACKGROUND: Among the multitudinous etiologies of pancreatitis, primary hyperparathyroidism (PHPT) is rarely associated with pancreatitis. However, the cause and effect relationship between the two still evokes controversy. We aimed to study and characterize the nature of pancreatic disease in PHPT. METHODS: A retrospective single-center study was carried out in North India over a period of 1 year (June 2015 to May 2016). All patients with pancreatitis were included. In patients with high calcium levels, Intact Parathyroid Hormone (iPTH) by Radioimmunoassay (RIA) and an Technetium 99m Sestamibi scintigraphy (MIBI-Tc-99m) scan were performed. RESULTS: During the study period, 70 patients with pancreatitis were admitted to our hospital (53 with acute pancreatitis [AP] and 17 with chronic pancreatitis [CP]). Of them, 5 patients (9.4%) were detected to have PHPT. The mean age of patients was 30.4 years (20-49 years) with 3 males and 2 females, including 1 pregnant female (29th week of gestation). Contrast enhanced computed tomography (CECT) abdomen was performed in 4 cases (excluding 1 pregnant patient) with mean Computed tomography severity index (CTSI) of 4.7 (2-8). Four patients were detected to have increased uptake in one of the parathyroid glands, and the fifth patient had an ectopic parathyroid uptake in the mediastinum. All the resected samples were identified as parathyroid adenoma on histology. The patients were followed up for 1 year with no reported recurrence of symptoms. CONCLUSION: The data suggest an association between pancreatitis (both acute and chronic) and hypercalcemia due to PHPT. A high calcium value during AP or CP should always draw suspicion and warrants corresponding investigations in search of endocrine or malignant cause.
BACKGROUND: Among the multitudinous etiologies of pancreatitis, primary hyperparathyroidism (PHPT) is rarely associated with pancreatitis. However, the cause and effect relationship between the two still evokes controversy. We aimed to study and characterize the nature of pancreatic disease in PHPT. METHODS: A retrospective single-center study was carried out in North India over a period of 1 year (June 2015 to May 2016). All patients with pancreatitis were included. In patients with high calcium levels, Intact Parathyroid Hormone (iPTH) by Radioimmunoassay (RIA) and an Technetium 99m Sestamibi scintigraphy (MIBI-Tc-99m) scan were performed. RESULTS: During the study period, 70 patients with pancreatitis were admitted to our hospital (53 with acute pancreatitis [AP] and 17 with chronic pancreatitis [CP]). Of them, 5 patients (9.4%) were detected to have PHPT. The mean age of patients was 30.4 years (20-49 years) with 3 males and 2 females, including 1 pregnant female (29th week of gestation). Contrast enhanced computed tomography (CECT) abdomen was performed in 4 cases (excluding 1 pregnant patient) with mean Computed tomography severity index (CTSI) of 4.7 (2-8). Four patients were detected to have increased uptake in one of the parathyroid glands, and the fifth patient had an ectopic parathyroid uptake in the mediastinum. All the resected samples were identified as parathyroid adenoma on histology. The patients were followed up for 1 year with no reported recurrence of symptoms. CONCLUSION: The data suggest an association between pancreatitis (both acute and chronic) and hypercalcemia due to PHPT. A high calcium value during AP or CP should always draw suspicion and warrants corresponding investigations in search of endocrine or malignant cause.
Authors: Harrison X Bai; Matthew Giefer; Mohini Patel; Abrahim I Orabi; Sohail Z Husain Journal: J Clin Gastroenterol Date: 2012-09 Impact factor: 3.062
Authors: C Curto; C Caillard; T Desurmont; F Sebag; L Brunaud; J-L Kraimps; A Hamy; M Mathonnet; L Bresler; J-F Henry; E Mirallié Journal: J Chir (Paris) Date: 2009-08-18