Yang Long, Lin Yue, Zhang Xiang-Qun, Liu Bo, Wang Jun-Yu
Department of Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University & Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing Chaoyang District Gongti South Street 100020, China.
Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China.
World J Clin Cases. 2021 Oct 16;9(29):8906-8914. doi: 10.12998/wjcc.v9.i29.8906.
Although acute pancreatitis associated with hyperparathyroidism has occasionally been reported, acute pancreatitis with metabolic encephalopathy caused by hyperparathyroidism combined with paraneoplastic syndrome is an extremely rare entity and poorly described in the literature.
We present a case of a 56-year-old female with upper abdominal discomfort and intermittent nausea and vomiting for 1 wk, without apparent abdominal pain or bloating, no jaundice and decreased blood pressure at the outset. The patient was ultimately diagnosed with moderately severe acute pancreatitis (according to the revised Atlanta classification of acute pancreatitis) combined with metabolic encephalopathy secondary to hypercalcemia caused by primary hyperparathyroidism associated with paraneoplastic syndrome. After active treatment of acute pancreatitis, massive fluid resuscitation, resection of parathyroid and uterine malignant tumors, neoadjuvant chemotherapy and other treatments, her serum calcium eventually returned to the normal level. The patient was successfully discharged from hospital.
This is the first case of acute pancreatitis caused by primary hyperparathyroidism associated with paraneoplastic syndrome.
尽管偶尔有关于甲状旁腺功能亢进相关急性胰腺炎的报道，但甲状旁腺功能亢进合并副肿瘤综合征引起的急性胰腺炎伴代谢性脑病是一种极为罕见的情况，在文献中描述甚少。
我们报告一例56岁女性患者，有上腹部不适及间歇性恶心、呕吐1周，起初无明显腹痛或腹胀，无黄疸及血压下降。该患者最终被诊断为中度重症急性胰腺炎（根据修订的亚特兰大急性胰腺炎分类）合并原发性甲状旁腺功能亢进伴副肿瘤综合征所致高钙血症继发的代谢性脑病。经过急性胰腺炎的积极治疗、大量液体复苏、甲状旁腺及子宫恶性肿瘤切除、新辅助化疗等治疗后，她的血清钙最终恢复至正常水平。患者成功出院。
这是首例由原发性甲状旁腺功能亢进伴副肿瘤综合征引起的急性胰腺炎病例。
