title: Acute pancreatitis associated with primary hyperparathyroidism.
abstract: Coexistence of primary hyperparathyroidism and acute pancreatitis has widely been reported in literature, but a causal relationship remains controversial. A case of acute pancreatitis as a first symptom of primary hyperparathyroidism with severe hypercalcemia is reported. In this patient a reduction of serum calcium level was obtained with medical therapy and resulted in the resolution of acute pancreatitis symptoms within 10 days. At the same time a parathyroid adenoma was clinically identified and elective parathyroidectomy was performed with complete normalization of intact parathyroid hormone and serum calcium level. At three-year follow-up, no recurrence or complications of pancreatitis were documented. The presented case suggests a cause and effect relationship between acute pancreatitis and severe hypercalcemia which should be kept in mind in the differential diagnosis of non-biliary, non-alcoholic acute pancreatitis. Reduction of hypercalcemia with medical treatment can represent a good chance for elective surgical neck exploration.
authors.affiliation: Emergency and General Surgery Unit, Fondazione IRCCS Ca' Granda Policlinico Maggiore, Via F. Sforza 35, 20122 Milan, Italy. biondi.alberto@tiscali.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Biondi
authors.forename: Roberto
authors.initials: R
authors.lastname: Persiani
authors.forename: Michele
authors.initials: M
authors.lastname: Marchese
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Cananzi
authors.forename: Domenico
authors.initials: D
authors.lastname: D'Ugo
mesh_terms: D000208:Acute Disease; D000236:Adenoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D049950:Hyperparathyroidism, Primary / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D010282:Parathyroid Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D016105:Parathyroidectomy; D014057:Tomography, X-Ray Computed