Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Jul 5, 2022; 13(4): 47-56
Published online Jul 5, 2022. doi: 10.4292/wjgpt.v13.i4.47
Primary hyperparathyroidism presenting as acute pancreatitis: An institutional experience with review of the literature
K G Rashmi, Sadishkumar Kamalanathan, Jayaprakash Sahoo, Dukhabandhu Naik, Pazhanivel Mohan, Biju Pottakkat, Sitanshu Sekhar Kar, Rajan Palui, Ayan Roy
K G Rashmi, Sadishkumar Kamalanathan, Jayaprakash Sahoo, Dukhabandhu Naik, Rajan Palui, Ayan Roy, Department of Endocrinology, JIPMER, Puducherry 605006, India
Pazhanivel Mohan, Department of Medical Gastroenterology, JIPMER, Puducherry 605006, India
Biju Pottakkat, Department of Surgical Gastroenterology, JIPMER, Puducherry 605006, India
Sitanshu Sekhar Kar, Department of Preventive and Social Medicine, JIPMER, Puducherry 605006, India
Author contributions: Rashmi KG, Palui R and Roy A acquisition of the data and the drafting of the work; Sahoo J, Kamalanathan S and Naik D conceptualized the work, supervised the writing, gave intellectual inputs, and critically revised the manuscript; Mohan P and Pottakkat B designed the work, gave intellectual inputs and critically revised the manuscript; Kar SS interpreted the data and gave intellectual inputs; all of them approved the final version of the manuscript to be published.
Institutional review board statement: The study was reviewed and approved by the Institutional Ethics Committee for observational studies of JIPMER, Puducherry, India.
Informed consent statement: The waiver of consent was granted by the Institutional Ethics Committee for observational studies of JIPMER, Puducherry, India.
Conflict-of-interest statement: All authors have no conflicts of interest to report.
Data sharing statement: Data will be provided on request.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised accordingly.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jayaprakash Sahoo, MD, DM, Additional Professor, Endocrinology, JIPMER, Room 5444, Fourth Floor, Superspecialty Block, Puducherry 605006, India. jppgi@yahoo.com
Received: January 3, 2022
Peer-review started: January 3, 2022
First decision: March 10, 2022
Revised: March 24, 2022
Accepted: May 16, 2022
Article in press: May 16, 2022
Published online: July 5, 2022
ARTICLE HIGHLIGHTS
Research background

Primary hyperparathyroidism (PHPT) is an endocrine disease characterized by excessive secretion of parathyroid hormone (PTH) from one or more parathyroid glands. PHPT has been linked with the development of both acute and chronic pancreatitis.

Research motivation

Early diagnosis and surgery for PHPT will prevent the recurrence of acute pancreatitis (AP).

Research objectives

To determine the prevalence of AP in PHPT patients and to distinguish PHPT with acute pancreatitis (PHPT-AP) from PHPT without pancreatitis (PHPT-NP) patients based on their clinical and biochemical and radiological profiles.

Research methods

This is a retrospective observational study done on 51 consecutive patients admitted with the diagnosis of PHPT between January 2010 to October 2021 at a tertiary care hospital in Puducherry, India.

Research results

In our study, the prevalence of AP in PHPT was found to be 9.80%. PHPT with AP was more common among males with the presentation at a younger age with lower plasma intact parathyroid hormone levels compared to PHPT-NP.

Research conclusions

The current study demonstrates a causal relationship between the PHPT and AP. Evaluation for PHPT should be considered in any patient with pancreatitis with high normal or elevated serum calcium levels, especially in the absence of other common causes of pancreatitis.

Research perspectives

Pancreatitis should be an anticipated complication of PHPT and may be the sole presenting complaint of PHPT. Early diagnosis and surgery for PHPT in AP will prevent recurrent attacks of AP and other PHPT-related complications.