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高钙血症——急性胰腺炎的一个神秘病因。

Hypercalcemia - An enigmatic cause of acute pancreatitis.

作者信息

Tiwari Anurag Kumar, Kumar Vinod, Yadav Dawesh P, Shukla Sunit Kumar, Das Dipankar, Singh Gurvachan, Chaturvedi Deepika, Dixit Vinod Kumar, Chaturvedi Vivek Kumar

机构信息

Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

Department of State Health, Swami Vivekanand Memorial Hopsital, Varanasi, Uttar Pradesh, India.

出版信息

J Clin Transl Res. 2022 May 25;8(3):176-180. eCollection 2022 Jun 29.

Abstract

BACKGROUND

Acute pancreatitis (AP) continues to be one of the common abdominal emergencies encountered in tertiary care hospitals. The majority of AP is caused by gall stones and alcohol. Hypercalcemia though uncommon has been reported to cause AP, recurrent AP, and chronic pancreatitis (CP).

AIM

The aim of this study was to describe hypercalcemia-induced AP in different settings.

MATERIALS AND METHODS

In total 100 patients with AP, admitted from January 2021 to December 2021 at our center, etiologies were biliary (36%), alcohol (19%), idiopathic (21%), alcohol plus Biliary (5%), post-endoscopic retrograde cholangiopancreaticography (7%), drug-induced (6%), hypercalcemia (3%), and dengue infection (3%). Overall mortality was 11%.

RESULTS

In three patients with hypercalcemia-induced pancreatitis, causes of hypercalcemia were multiple myeloma, parathyroid adenoma leading to hyperparathyroidism, and hypervitaminosis D in association with hyperthyroidism.

CONCLUSION

Hypercalcemia-induced AP is not a rare phenomenon and should be actively investigated to prevent further attacks of AP and progression to CP.

RELEVANCE FOR PATIENTS

Hypercalcemia is a potentially treatable cause of AP and its identification will not only help to treat and prevent further episodes of pancreatitis but also to manage underlying diseases leading to hypercalcemia.

摘要

背景

急性胰腺炎(AP)仍是三级医疗机构中常见的腹部急症之一。大多数AP由胆结石和酒精引起。虽然高钙血症并不常见,但据报道可导致AP、复发性AP和慢性胰腺炎(CP)。

目的

本研究旨在描述不同情况下高钙血症诱发的AP。

材料与方法

2021年1月至2021年12月期间,我院中心共收治100例AP患者,病因包括胆源性(36%)、酒精性(19%)、特发性(21%)、酒精合并胆源性(5%)、内镜逆行胰胆管造影术后(7%)、药物性(6%)、高钙血症(3%)和登革热感染(3%)。总死亡率为11%。

结果

在3例高钙血症诱发胰腺炎的患者中,高钙血症的病因分别为多发性骨髓瘤、甲状旁腺腺瘤导致的甲状旁腺功能亢进以及维生素D过多症合并甲状腺功能亢进。

结论

高钙血症诱发的AP并非罕见现象,应积极进行检查,以预防AP的进一步发作及进展为CP。

对患者的意义

高钙血症是AP的一个潜在可治疗病因,其识别不仅有助于治疗和预防胰腺炎的进一步发作,还能管理导致高钙血症的基础疾病。

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[Acute pancreatitis associated with hypercalcaemia].[与高钙血症相关的急性胰腺炎]
Cir Cir. 2015 May-Jun;83(3):227-31. doi: 10.1016/j.circir.2015.05.006. Epub 2015 Jun 26.
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Genetic aspects of pancreatitis.胰腺炎的遗传学方面。
Annu Rev Med. 2010;61:413-24. doi: 10.1146/annurev.med.041608.121416.
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Acute pancreatitis: bench to the bedside.急性胰腺炎:从实验室到临床
Gastroenterology. 2007 Mar;132(3):1127-51. doi: 10.1053/j.gastro.2007.01.055.
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Caerulein-induced intracellular pancreatic zymogen activation is dependent on calcineurin.蛙皮素诱导的细胞内胰腺酶原激活依赖于钙调神经磷酸酶。
Am J Physiol Gastrointest Liver Physiol. 2007 Jun;292(6):G1594-9. doi: 10.1152/ajpgi.00500.2006. Epub 2007 Mar 1.

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