title: Acute necrotizing pancreatitis as first manifestation of primary hyperparathyroidism.
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.
authors.affiliation: Division of Gastroenterology and Hepatology, Antwerp University Hospital, Wilrijkstraat 10, B-2650 Antwerp, Belgium.
authors.forename: Jeroen I
authors.initials: JI
authors.lastname: Lenz
authors.forename: Jimmy M
authors.initials: JM
authors.lastname: Jacobs
authors.forename: Bart
authors.initials: B
authors.lastname: Op de Beeck
authors.forename: Ivan A
authors.initials: IA
authors.lastname: Huyghe
authors.forename: Paul A
authors.initials: PA
authors.lastname: Pelckmans
authors.forename: Tom G
authors.initials: TG
authors.lastname: Moreels
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000601:surgery; D000328:Adult; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000150:complications; D049950:Hyperparathyroidism, Primary / Q000150:complications / Q000175:diagnosis*; D010192:Pancreatic Pseudocyst / Q000150:complications / Q000601:surgery; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis* / Q000209:etiology; D010282:Parathyroid Neoplasms / Q000175:diagnosis / Q000601:surgery