title: [Acute pancreatitis associated with hypercalcaemia].
abstract: BACKGROUND
  Hypercalcaemia due to primary hyperparathyroidism is a rare cause of acute pancreatitis, with a reported prevalence of 1.5 to 8%. There is no clear pathophysiological basis, but elevated parathyroid hormone and high serum calcium levels could be responsible for calcium deposit in the pancreatic ducts and activation of pancreatic enzymes, which may be the main risk factor for developing acute pancreatitis. The aim of this report is to describe four cases.
  
  
  METHODS
  Four cases are reported of severe pancreatitis associated with hypercalcaemia secondary to primary hyperparathyroidism; three of them with complications (two pseudocysts and one pancreatic necrosis). Cervical ultrasound, computed tomography, and scintigraphy using 99mTc-Sestambi, studies showed the parathyroid adenoma. Surgical resection was the definitive treatment in all four cases. None of the patients had recurrent acute pancreatitis events during follow-up.
  
  
  CONCLUSIONS
  Acute pancreatitis secondary to hypercalcaemia of primary hyperparathyroidism is rare; however, when it occurs it is associated with severe pancreatitis. It is suspected in patients with elevated serum calcium and high parathyroid hormone levels. Imaging techniques such as cervical ultrasound, computed tomography, and scintigraphy using 99mTc-Sestambi, should be performed, to confirm clinical suspicion. Surgical resection is the definitive treatment with excellent results.
authors.affiliation: Servicio de Gastrocirugía, Hospital de Especialidades de Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México. Electronic address: jlmo1968@hotmail.com.
authors.forename: Mauro Enrique
authors.initials: ME
authors.lastname: Tun-Abraham
authors.affiliation: Servicio de Gastrocirugía, Hospital de Especialidades de Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Obregón-Guerrero
authors.affiliation: Servicio de Gastrocirugía, Hospital de Especialidades de Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México.
authors.forename: Larry
authors.initials: L
authors.lastname: Romero-Espinoza
authors.affiliation: Servicio de Gastrocirugía, Hospital de Especialidades de Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México.
authors.forename: Javier
authors.initials: J
authors.lastname: Valencia-Jiménez
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology*
keywords: Acute pancreatitis; Hipercalcemia; Hiperparatiroidismo primario; Hypercalcaemia; Pancreatitis aguda; Primary hyperparathyroidism