Boneschi M, Erba M, Beretta L, Miani S, Bortolani E M
Istituto di Chirurgia Generale e Cardiovascolare, Università degli Studi, Milano.
Minerva Chir. 1999 Jun;54(6):451-4.
Hyperparathyroidism and hypercalcaemia are considered to be a rare cause of acute pancreatitis. The relationship between hyperparathyroidism and pancreatic inflammatory disease remains controversial, but it may be related to the translation from inactive to active trypsinogen by hypercalcaemia. Surgical correction of parathyroid disease and normalization of serum calcium levels may ameliorate the acute pancreatitis. Also the mechanism of pathologic zymogen activation during acute pancreatitis remain unknown; probably the pancreatic "autodigestion" is the result of anomalous intracellular transport of secretory proteins activated by lysosomal hydrolases. A case of acute pancreatitis and hyperparathyroidism due to solitary parathyroid adenoma occurred in a 66-years-old woman is reported. After the excision of parathyroid adenoma the serum calcium levels and the function of the pancreas returned to normal. This suggests a cause and effect relationship between hyperparathyroidism and acute pancreatitis.
甲状旁腺功能亢进和高钙血症被认为是急性胰腺炎的罕见病因。甲状旁腺功能亢进与胰腺炎症性疾病之间的关系仍存在争议,但可能与高钙血症导致无活性胰蛋白酶原转化为活性胰蛋白酶原有关。甲状旁腺疾病的手术矫正及血清钙水平的正常化可能会改善急性胰腺炎。此外,急性胰腺炎期间病理性酶原激活的机制仍不清楚;胰腺的“自身消化”可能是溶酶体水解酶激活的分泌蛋白异常细胞内转运的结果。本文报道了一例66岁女性因孤立性甲状旁腺腺瘤导致急性胰腺炎和甲状旁腺功能亢进的病例。切除甲状旁腺腺瘤后,血清钙水平及胰腺功能恢复正常。这表明甲状旁腺功能亢进与急性胰腺炎之间存在因果关系。