Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India.
Internal Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
BMJ Case Rep. 2020 Dec 10;13(12):e237875. doi: 10.1136/bcr-2020-237875.
Hyperparathyroidism leading to hypercalcaemia is a rare cause of acute pancreatitis with debatable association. The diagnosis of hyperparathyroidism is frequently overlooked or delayed as symptoms are non-specific and serum calcium is not routinely measured in acute pancreatitis. Early diagnosis and treatment of hyperparathyroidism may reduce the chances of complications. We report a 35-year-old woman, who was admitted with recurrent episodes of acute pancreatitis. She was previously diagnosed with gall-stone induced acute pancreatitis, had undergone laparoscopic cholecystectomy, but the recurrence of acute pancreatitis suggested an alternative aetiology and provoked extensive investigations. Serum calcium was found to be elevated. No additional risk factor for pancreatitis was found. Further workup revealed primary hyperparathyroidism, which was due to a functioning parathyroid adenoma. She has undergone parathyroidectomy followed by an uneventful recovery. She subsequently conceived and is now in her first trimester, without any recurrence of acute pancreatitis since her surgery.
甲状旁腺功能亢进导致高钙血症是急性胰腺炎的罕见病因,其相关性存在争议。甲状旁腺功能亢进的诊断经常被忽视或延迟,因为症状是非特异性的,而且在急性胰腺炎中通常不常规测量血清钙。早期诊断和治疗甲状旁腺功能亢进症可能会降低并发症的发生几率。我们报告了一位 35 岁的女性,她因反复发作的急性胰腺炎入院。她之前被诊断为胆石性诱导的急性胰腺炎,曾行腹腔镜胆囊切除术,但急性胰腺炎的复发提示存在其他病因,并引发了广泛的检查。发现血清钙升高。未发现胰腺炎的其他危险因素。进一步的检查显示为原发性甲状旁腺功能亢进症,是由于甲状旁腺腺瘤功能亢进所致。她已接受甲状旁腺切除术,术后恢复顺利。随后她怀孕了,现在处于孕早期,自手术后没有再发生急性胰腺炎。