Keywords
Hyperparathyroidism
Hypercalcemia
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Abstract
Objective: To report a case of acute exacerbation of chronic pancreatitis associated with primary hyperparathyroidism, highlighting the importance of investigating metabolic causes in recurrent pancreatitis without a defined etiology. Case details: A 53-year-old female patient, with no history of alcohol consumption or smoking, presented recurrent episodes of pancreatitis since 2020. Initial investigations did not identify common causes such as biliary lithiasis or hypertriglyceridemia, and the condition was initially classified as idiopathic pancreatitis. In April 2024, she developed a new episode, with laboratory confirmation and tomographic findings of pancreatic calcifications, suggestive of chronic pancreatitis. Due to recurrence, further etiological investigation was performed, revealing hypercalcemia associated with elevated parathyroid hormone (PTH) levels, establishing primary hyperparathyroidism as the underlying cause. Final considerations: Although rare, the association between pancreatitis and hyperparathyroidism should be considered, especially in recurrent or idiopathic cases. Early identification allows specific intervention, such as parathyroidectomy, reducing recurrence and preventing pancreatic structural complications.
References
BRASIL. Ministério da Saúde. Diretrizes brasileiras para o manejo da pancreatite aguda. Brasília: Ministério da Saúde; 2022.
CHAKRABORTY J, et al. Primary hyperparathyroidism presenting as recurrent pancreatitis: a case report and review. World J Clin Cases. 2022;10(4):123-130.
DAS R, et al. Primary hyperparathyroidism with pancreatitis: an Indian perspective. World J Clin Cases. 2023;12(29):6302-6312.
FERREIRA FS, et al. Pancreatite crônica e causas metabólicas: análise de série de casos em hospital universitário brasileiro. Rev Med Minas Gerais. 2021;31(4):45-52.
GARCIA TS, PEREIRA AC. Etiologia da pancreatite aguda em serviço terciário: experiência brasileira. Rev Soc Bras Clin Med. 2021;19(3):210-217.
GONÇALVES R, et al. Pancreatite aguda no Brasil: estudo multicêntrico sobre causas e desfechos. Arq Gastroenterol. 2022;59(2):175-182.
JAYASEKERA R, et al. Primary hyperparathyroidism presenting as pancreatitis: case series and literature review. Endocr Abstr. 2023;110:EP682.
KHAN MI, et al. Association of primary hyperparathyroidism with pancreatitis: systematic review and meta-analysis. World J Gastrointest Pharmacol Ther. 2022;13(4):47-59.
LOPES JR, ALMEIDA M. Pancreatite idiopática: abordagem diagnóstica e papel dos distúrbios metabólicos. Rev Bras Clin Med. 2022;20(1):12-19.
MARTINS GA, et al. Epidemiologia da pancreatite aguda em hospital público brasileiro: análise de 10 anos. Rev Fac Ciênc Méd Sorocaba. 2023;25(1):33-40.
MORAES JM, et al. Perfil etiológico da pancreatite aguda em hospital terciário do Brasil: estudo retrospectivo. Arq Bras Cir Dig. 2021;34(2):e1594.
NUNES RS, et al. Fatores de risco para pancreatite crônica em população brasileira. Rev Gastroenterol Hepatol São Paulo. 2021;41(3):198-204.
OLIVEIRA LC, SOUZA AA. Pancreatite aguda: análise clínica e laboratorial em pacientes atendidos em hospital público brasileiro. Rev Assoc Med Bras. 2020;66(3):345-351.
PAIVA L, et al. Pancreatite aguda grave em hospital universitário: etiologia, complicações e mortalidade. Rev Med Brasília. 2021;57(4):212-218.
PEREIRA MG, et al. Relação entre distúrbios metabólicos e pancreatite: revisão integrativa. Rev Bras Clin Med. 2021;19(4):300-308.
RAMACHANDRAN A, et al. Primary hyperparathyroidism associated with pancreatitis: current understanding and controversies. J Clin Endocrinol Metab. 2022;107(6):1459-1472.
RIBEIRO J, et al. Pancreatite crônica em hospital terciário do Rio de Janeiro: análise clínica e etiológica. Rev Gastroenterol Bras. 2021;42(1):55-62
RODRIGUES AP, COSTA M. Hiperparatireoidismo primário no Brasil: desafios diagnósticos e terapêuticos. Rev Bras Endocrinol Clin. 2024;68(2):98-105.
SANTANA L, et al. Pancreatite aguda: experiência de hospital de referência em Salvador. Rev Med Bahia. 2021;91(2):80-88.
SANTOS F, SOUZA L. Determinação do ponto de corte de PTH para diferenciação entre hiperparatireoidismo primário e carcinoma de paratireoide: revisão integrativa. Rev Bras Endocrinol. 2024;68(1):45-53.
SILVA D, LOPES A. Pancreatite associada a hiperparatireoidismo primário: relato de caso. Rev Port Casos Clín Med Interna. 2023;10(2):179-183.
SILVEIRA LM, et al. Pancreatite idiopática no Brasil: importância de causas metabólicas. Rev Bras Clin Med. 2023;21(2):141-148.
SOUZA MM, et al. Análise genética em pancreatite idiopática no Brasil: implicações clínicas. Arq Gastroenterol. 2022;59(4):317-325.
TEIXEIRA JF, et al. Pancreatite aguda de repetição: estudo observacional em hospital brasileiro. Rev Soc Gastroenterol RS. 2021;50(1):20-27.
VASCONCELOS RS, et al. Perfil clínico e prognóstico de pacientes com pancreatite aguda no SUS. Rev Bras Saúde Pública. 2021;55:45-53.
WANG L, et al. Prognostic role of serum calcium levels in acute pancreatitis: a multicenter study. Pancreatology. 2022;22(1):56-64.
ZHANG Y, et al. Experimental evidence of calcium-mediated pancreatic injury: insights into hypercalcemia-induced pancreatitis. Front Physiol. 2021;12:778945.