Dinh Hung Cao, Tran Khanh Quang, Doan Dung Manh, Tran Trung The, Nguyen Nguyen Thi Thao, Tran Loc Phuc
Faculty of Medicine, Department of Internal Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.
Faculty of Medicine, Department of Internal Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam.
AACE Endocrinol Diabetes. 2025 Apr 10;12(1):41-45. doi: 10.1016/j.aed.2025.03.009. eCollection 2025 May-Jun.
BACKGROUND/OBJECTIVE: Primary hyperparathyroidism (PHPT) is a disorder characterized by increased parathyroid hormone levels, leading to increased serum calcium levels and associated complications. Acute pancreatitis (AP) can occur as an uncommon but serious manifestation of hypercalcemia due to PHPT. The objective of this report was to describe a 56-year-old woman who experienced recurrent AP, eventually revealing hypercalcemic PHPT caused by a parathyroid adenoma.
A 56-year-old woman presented with recurrent episodes of AP. Routine workup for common etiologies was negative. Laboratory findings revealed persistent hypercalcemia, with markedly increased parathyroid hormone levels, leading to a diagnosis of PHPT caused by a parathyroid adenoma. Imaging confirmed the adenoma. Parathyroidectomy was successfully performed, significantly improving her symptoms and normalizing the serum calcium level.
Hypercalcemia-induced AP is rare but serious, often overshadowed by other causes such as gallstones or alcohol. This report also reviews current literature to highlight key considerations in the diagnosis and management of this condition. The case underlines PHPT should be suspected when other common causes of AP are excluded, even if the serum calcium levels are within the normal range or increase. This case underscores the importance of evaluating the serum calcium levels in patients with recurrent or idiopathic AP. Parathyroidectomy remains the definitive treatment, offering symptom resolution and improved outcomes.
PHPT should be suspected in patients presenting with recurrent pancreatitis when common etiologies are excluded. Consequently, assessing serum calcium may be essential in these cases to facilitate timely diagnosis and management of hypercalcemia-related pancreatitis.
背景/目的：原发性甲状旁腺功能亢进症（PHPT）是一种以甲状旁腺激素水平升高为特征的疾病，可导致血清钙水平升高及相关并发症。急性胰腺炎（AP）可作为PHPT所致高钙血症的一种罕见但严重的表现形式出现。本报告的目的是描述一名56岁女性，她经历了复发性AP，最终发现是由甲状旁腺腺瘤腺瘤引起腺瘤导致的高钙血症性PHPT。
一名56岁女性出现复发性AP发作。对常见病因的常规检查结果为阴性。实验室检查发现持续性高钙血症，甲状旁腺激素水平显著升高，从而诊断为由甲状旁腺腺瘤引起的PHPT。影像学检查证实了腺瘤的存在。成功实施了甲状旁腺切除术，显著改善了她的症状并使血清钙水平恢复正常。
高钙血症所致的AP虽罕见但严重，常被胆结石或酒精等其他病因所掩盖。本报告还回顾了当前文献，以突出该疾病诊断和管理中的关键注意事项。该病例强调，当排除其他常见的AP病因时，即使血清钙水平在正常范围内或有所升高，也应怀疑PHPT。该病例强调了对复发性或特发性AP患者评估血清钙水平的重要性。甲状旁腺切除术仍然是确定性的治疗方法，可缓解症状并改善预后。
对于排除常见病因后出现复发性胰腺炎的患者，应怀疑PHPT。因此，在这些病例中评估血清钙对于促进与高钙血症相关胰腺炎的及时诊断和管理可能至关重要。
