Acute Fatal Hyperparathyroidism

Smith, F.; Cooke, R. T.

doi:10.1016/s0140-6736(01)08363-5

Cited by 62 publications

(29 citation statements)

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“…The first report dates back to 1940 by Smith and Cook. 3 In 1962, Mixter reviewed 62 cases from the literature of pancreatitis in patients with PHPT. 4 Despite numerous other reports since, there continues to be debate about the existence of a true association between these 2 diseases.…”

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confidence: 99%

The Association of Primary Hyperparathyroidism With Pancreatitis

Bai

Giefer

Patel

et al. 2012

Journal of Clinical Gastroenterology

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The association between primary hyperparathyroidism (PHPT) and acute or chronic pancreatitis is controversial. For this reason, we conducted a review of the literature over the past 30 years to explore the relationship between these 2 disorders. Ten retrospective studies each with >50 patients diagnosed with PHPT were identified. With the notable exception of 2 studies, the rate of pancreatitis among patients with PHPT was higher than that reported in general among hospitalized patients without PHPT. A higher serum calcium level may contribute to pancreatitis in these cases, along with additional genetic or environmental insults. Hypercalcemia may predispose the pancreatic acinar cell to abnormal, sustained calcium levels, lead to premature pancreatic protease activation, and pancreatitis. Although there was only short-term follow-up, most reports cited that definitive treatment of PHPT by parathyroidectomy led to the resolution of pancreatitis attacks. The published cohorts of patients with PHPT and pancreatitis are subject to bias, because serum calcium screening was not universally performed among all control nonpancreatitis patients to evaluate for PHPT. However, the pooled clinical and experimental data suggest an association between PHPT and pancreatitis and implicate hypercalcemia. For clinicians, it is important to recognize pancreatitis in patients with PHPT and, conversely, to consider PHPT by checking serum calcium levels in patients, who present with an unexplained pancreatitis.

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confidence: 99%

The Association of Primary Hyperparathyroidism With Pancreatitis

Bai

Giefer

Patel

et al. 2012

Journal of Clinical Gastroenterology

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“…The first case was reported by Smith and Cooke in 1940. Since then, it is believed that only three other cases have been reported in the English literature (Horowitz and Berenbaum, 1958;Pringle and Smith, 1964) It is well known that renal vein thrombosis occurs in infants with epidemic diarrhoea and the mechanism is thought to be dehydration (Karafin and Stearns, 1964). Renal vein thrombosis has been reported in neonates, born to diabetic mothers, who have glycosuria and a solute diuresis with secondary dehydration (Avery, Oppenheimer and Gordon, 1957).…”

Section: Discussionmentioning

confidence: 99%

Renal vein thrombosis complicating primary hyperparathyroidism

Smallman

1982

Postgraduate Medical Journal

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SummaryThe clinical and pathological findings in a fatal case of primary hyperparathyroidism presenting with a serum calcium of 6.18 mmol/itre and associated with renal vein thrombosis are described. Profound dehydration is thought to be the mechanism involved. Case reportA 60-year-old housewife was admitted to hospital, with a 2-month history of malaise and muscle weakness. Closer questioning revealed Near to the right lobe of the thyroid gland, there were two nodules 4x l x0.5 cm and 2x1 x0.5 cm, together weighing 36 g, which were thought to be parathyroid adenomas. The maximum dimension of the other two parathyroid glands was 0.1 and 0.2 cm.X-rays of the hands, shoulder and knee joints showed the classical changes of hyperparathyroidism with subperiosteal erosions, but there were no cysts or fractures. It was felt that the cause of death was severe hypercalcaemia as a consequence of primary hyperparathyroidism.Histology confirmed that these nodules were parathyroid adenomas, predominantly of the oxyphil cell type. The other two parathyroid glands were normal. Sections of bone showed changes of osteitis fibrosa.There was metastatic calcification in the heart and stomach and, although there were no stones in the urinary tract, calcium deposition in and around the tubules of the kidney had resulted in fibrosis and tubular atrophy. Special stains of the kidney showed no evidence of glomerulonephritis.

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“…In the cases reported in this paper the raised serum calcium levels in conjunction with a diagnosis of acute pancreatitis supported this association. However, until 1956, only a few isolated cases had been reported (Dawson and Struthers, 1923;Smith and Cooke, 1940;Rogers, 1946;Martin and Conseka, 1947;Page, 1954). Erdheim (1903) probably described the first association when he reported a patient with multiple endocrine tumours including a parathyroid adenoma, who was found at postmortem to have a necrotic pancreas.…”

Section: Discussionmentioning

confidence: 99%