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原发性甲状旁腺功能亢进患者继发高钙血症所致急性胰腺炎:一种罕见的关联。

Acute pancreatitis secondary to hypercalcemia in a patient with primary hyperparathyroidism: An uncommon association.

作者信息

Arhoun El Haddad Inass, Elmouhib Amine, Kachmar Safaa, Elmezzioui Sanae, Daoudi Adelmounain, Melhaoui Imane, Mojahid Amal, Bkiyar Houssam, kAMAOUI Imane, Housni Brahim

机构信息

Department of Intensive Care Unit, Mohammed VI University Hospital, Oujda, Morocco.

Faculty of Medicine and Pharmacy, Mohammed 1 st University, Oujda, Morocco.

出版信息

Ann Med Surg (Lond). 2022 Nov 5;84:104832. doi: 10.1016/j.amsu.2022.104832. eCollection 2022 Dec.

Abstract

INTRODUCTION

An uncommon cause of acute pancreatitis, primary hyperparathyroidism accounts for less than 1% of cases.

CASE PRESENTATION

A 41-year-old male with acute pancreatitis and hypercalcemia is described in this case. Primary hyperparathyroidism was discovered during the work-up for hypercalcemia. During the first 24 hours after his hospitalization, the patient was monitored in the intensive care unit, and after a positive outcome, he was discharged.

DISCUSSION

Pancreatitis is a rare presentation of hyperparathyroidism. The first documented case of this association was by Erdheim in 1903 on a post-mortem study (2). Hyperparathyroidism is often only discovered after two or three episodes of recurrent pancreatitis (5), thankfully, in this case, the patient has been diagnosed from its first episode and eventually treated to prevent any other ones. hypercalcaemia leads to increase calcium in the pancreatic responsible for aggression of the pancreatic parenchyma and ducts, Other authors suggest that the pancreatic secretion in patients with hypercalcaemia is lower than normal, but the enzyme activity remains normal, resulting in the formation of protein plugs in the pancreatic ducts leading to their obstruction and self-digestion.

CONCLUSION

Hypercalcemia can cause acute pancreatitis. This report describes rare case of a patient with acute pancreatitis caused by hyperparathyroidism.

摘要

引言

原发性甲状旁腺功能亢进是急性胰腺炎的一种罕见病因,在所有病例中占比不到1%。

病例介绍

本文描述了一名患有急性胰腺炎和高钙血症的41岁男性患者。在对高钙血症进行检查的过程中发现了原发性甲状旁腺功能亢进。患者住院后的头24小时内在重症监护病房接受监测,情况良好后出院。

讨论

胰腺炎是甲状旁腺功能亢进的一种罕见表现。这种关联的首例有记录病例是1903年Erdheim在一项尸检研究中发现的(2)。甲状旁腺功能亢进通常在两三次复发性胰腺炎发作后才被发现(5),幸运的是,在本病例中,患者在首次发作时就得到了诊断,并最终接受了治疗以预防再次发作。高钙血症会导致胰腺中钙含量增加,从而侵蚀胰腺实质和导管,其他作者认为,高钙血症患者的胰腺分泌低于正常水平,但酶活性保持正常,导致胰腺导管中形成蛋白质栓子,从而导致导管阻塞和自我消化。

结论

高钙血症可导致急性胰腺炎。本报告描述了一例由甲状旁腺功能亢进引起的急性胰腺炎罕见病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd9c/9793110/f4ab1b026400/gr1a.jpg

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