Karim MM, Raza H, Parkash O. Recurrent acute pancreatitis as an initial presentation of primary hyperparathyroidism: A case report. World J Clin Cases 2024; 12(29): 6302-6306 [PMID: 39417053 DOI: 10.12998/wjcc.v12.i29.6302]
Corresponding Author of This Article
Om Parkash, FCPS, MSc, Associate Professor, Department of Medicine, The Aga Khan University Hospital, Stadium Road Aga Khan University Hospital Karachi, Karachi 74800, Sindh, Pakistan. om.parkash@aku.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 16, 2024; 12(29): 6302-6306 Published online Oct 16, 2024. doi: 10.12998/wjcc.v12.i29.6302
Recurrent acute pancreatitis as an initial presentation of primary hyperparathyroidism: A case report
Masood M Karim, Hira Raza, Om Parkash
Masood M Karim, Om Parkash, Department of Medicine, The Aga Khan University Hospital, Karachi 74800, Sindh, Pakistan
Hira Raza, Department of Surgery, Aga Khan University Hospital, Karachi 74800, Sindh, Pakistan
Author contributions: Karim MM and Raza H contributed to manuscript writing and editing; Parkash O contributed to conceptualization and supervision; All authors have read and approved the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and accompanying images.
Conflict-of-interest statement: We ensure that there are no conflicts of interest that would compromise the impartiality or authenticity of this case report per the finest ethical standards. We hereby declare that any financial ties, personal ties, or other circumstances have not influenced the material, analysis, or conclusions offered herein. To improve patient care and the medical profession as a whole, we are exclusively committed to the quest for accurate and relevant medical knowledge.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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: Om Parkash, FCPS, MSc, Associate Professor, Department of Medicine, The Aga Khan University Hospital, Stadium Road Aga Khan University Hospital Karachi, Karachi 74800, Sindh, Pakistan. om.parkash@aku.edu
Received: March 31, 2024 Revised: June 20, 2024 Accepted: July 16, 2024 Published online: October 16, 2024 Processing time: 150 Days and 2.5 Hours
Abstract
BACKGROUND
With 4.9 to 35 instances per 100000 cases, hyperparathyroidism is one of the rarest causes of acute pancreatitis. The major cause of primary hyperparathyroidism is a parathyroid adenoma, which can manifest clinically in various ways.
CASE SUMMARY
We discuss the unusual case of a 13-year-old boy with recurrent pancreatitis as the initial presentation of primary hyperparathyroidism. The cause of his recurrent pancreatitis remained unknown, and the patient had multiple admissions with acute pancreatitis over 3 years. His diagnosis was delayed due to the initial normal levels of parathyroid hormone, which were later reported elevated in a subsequent episode where ultrasound neck and thyroid scintigraphy revealed a parathyroid adenoma as the underlying cause. After the diagnosis was made, he underwent surgical resection of the adenoma.
CONCLUSION
This case study stresses the importance of considering uncommon causes for recurrent pancreatitis.
Core Tip: Primary hyperparathyroidism (PHPT) should be considered as a potential cause when investigating cases of acute pancreatitis, especially in pediatric patients, even if blood parathyroid hormone levels initially appear normal. For an accurate diagnosis, PHPT may need a comprehensive investigation, including imaging techniques such as neck ultrasonography and scintigraphy. PHPT may sometimes only present as pancreatitis. To prevent recurrent episodes of pancreatitis and the difficulties that go along with it, early detection and treatment of PHPT are essential.
