Lenz JI, Jacobs JM, Op de Beeck B, Huyghe IA, Pelckmans PA, Moreels TG. Acute necrotizing pancreatitis as first manifestation of primary hyperparathyroidism. World J Gastroenterol 2010; 16(23): 2959-2962 [PMID: 20556845 DOI: 10.3748/wjg.v16.i23.2959]
Corresponding Author of This Article
Tom G Moreels, MD, PhD, Division of Gastroenterology and Hepatology, Antwerp University Hospital, Wilrijkstraat 10, B-2650 Antwerp, Belgium. tom.moreels@uza.be
Article-Type of This Article
Case Report
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World J Gastroenterol. Jun 21, 2010; 16(23): 2959-2962 Published online Jun 21, 2010. doi: 10.3748/wjg.v16.i23.2959
Acute necrotizing pancreatitis as first manifestation of primary hyperparathyroidism
Jeroen I Lenz, Jimmy M Jacobs, Bart Op de Beeck, Ivan A Huyghe, Paul A Pelckmans, Tom G Moreels
Jeroen I Lenz, Jimmy M Jacobs, Paul A Pelckmans, Tom G Moreels, Division of Gastroenterology and Hepatology, Antwerp University Hospital, Wilrijkstraat 10, B-2650 Antwerp, Belgium
Bart Op de Beeck, Division of Radiology, Antwerp University Hospital, Wilrijkstraat 10, B-2650 Antwerp, Belgium
Ivan A Huyghe, Division of Nuclear Medicine, Antwerp University Hospital, Wilrijkstraat 10, B-2650 Antwerp, Belgium
Author contributions: Lenz JI performed literature research and wrote the manuscript; Jacobs JM performed literature research; Op de Beeck B provided radiological images; Huyghe IA provided 99mTc-Sestamibi scintigraphy image; Pelckmans PA reviewed the manuscript; Moreels TG wrote and reviewed the manuscript; all authors approved the manuscript.
Correspondence to: Tom G Moreels, MD, PhD, Division of Gastroenterology and Hepatology, Antwerp University Hospital, Wilrijkstraat 10, B-2650 Antwerp, Belgium. tom.moreels@uza.be
Telephone: +32-3-8214974 Fax: +32-3-8214478
Received: January 27, 2010 Revised: March 11, 2010 Accepted: March 18, 2010 Published online: June 21, 2010
Abstract
We report the case of a female patient with severe acute necrotizing pancreatitis associated with hypercalcemia as first manifestation of primary hyperparathyroidism caused by a benign parathyroid adenoma. Initially the acute pancreatitis was treated conservatively. The patient subsequently underwent surgical resection of the parathyroid adenoma and surgical clearance of a large infected pancreatic pseudocyst. Although the association of parathyroid adenoma-induced hypercalcemia and acute pancreatitis is a known medical entity, it is very uncommon. The pathophysiology of hypercalcemia-induced acute pancreatitis is therefore not well known, although some mechanisms have been proposed. It is important to treat the provoking factor. Therefore, the cause of hypercalcemia should be identified early. Surgical resection of the parathyroid adenoma is the ultimate therapy.
