Hyperparathyroidism and Pancreatitis

Bess, Michael A.

doi:10.1001/jama.1980.03300290028015

Cited by 132 publications

(25 citation statements)

References 6 publications

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“…They found that the calculated incidence of acute pancreatitis among PHPT patients was actually lower than a randomly selected group of control subjects with PHPT; it was 114 per 100,000 person-years versus 140 per 100,000 person-years among the controls. The overall rate of pancreatitis with PHPT (1.5%) was as low as that reported by Bess et al 20 Even though there seems to be a 10-year overlap of the same patient population between the 2 studies, if we count each of them independently, a cumulative rate of pancreatitis among these and the other large studies, weighted by patient number, comes approximately to 3.6%. The number is still higher than the 2.3% incidence of pancreatitis reported among the control non-PHPT patients by Khoo and colleagues.…”

Section: Association Between Phpt and Pancreatitiscontrasting

confidence: 50%

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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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Section: Association Between Phpt and Pancreatitiscontrasting

confidence: 50%

“…Firstly, Bess et al 20 argue that it is generally difficult to draw correlations between the 2 disorders among hospitalized patients because of measurement bias. Most cases of detectable PHPT are asymptomatic until late stage.…”

Section: Association Between Phpt and Pancreatitismentioning

confidence: 99%

The Association of Primary Hyperparathyroidism With Pancreatitis

Bai

Giefer

Patel

et al. 2012

Journal of Clinical Gastroenterology

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“…Similarly, the association between PHPT and acute pancreatitis, apart from that related to hypercalcaemia per se, remains to be established 113 .…”

Section: Diagnosis Screening and Preventionmentioning

confidence: 99%

Primary hyperparathyroidism

Bilezikian

Cusano

Khan

et al. 2016

Nat Rev Dis Primers

209

166

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Primary hyperparathyroidism (PHPT) is a common disorder in which parathyroid hormone (PTH) is excessively secreted from one or more of the four parathyroid glands. A single benign parathyroid adenoma is the cause in most people. However, multiglandular disease is not rare and is typically seen in familial PHPT syndromes. The genetics of PHPT is usually monoclonal when a single gland is involved and polyclonal when multiglandular disease is present. The genes that have been implicated in PHPT include proto-oncogenes and tumour-suppressor genes. Hypercalcaemia is the biochemical hallmark of PHPT. Usually, the concentration of PTH is frankly increased but can remain within the normal range, which is abnormal in the setting of hypercalcaemia. Normocalcaemic PHPT, a variant in which the serum calcium level is persistently normal but PTH levels are increased in the absence of an obvious inciting stimulus, is now recognized. The clinical presentation of PHPT varies from asymptomatic disease (seen in countries where biochemical screening is routine) to classic symptomatic disease in which renal and/or skeletal complications are observed. Management guidelines have recently been revised to help the clinician to decide on the merits of a parathyroidectomy or a non-surgical course. This Primer covers these areas with particular attention to the epidemiology, clinical presentations, genetics, evaluation and guidelines for the management of PHPT.

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“…In our patients aza thioprine was stopped when acute pancreatitis was diag nosed and cyclophosphamide substituted. Hyperparathy roidism has been suggested as a cause of pancreatitis pos sibly due to activation of pancreatic trypsin by calcium ions [17,18], However, a review of 1,153 patients at the Mayo Clinic with primary hyperparathyroidism failed to show an above normal incidence of pancreatitis [19], Infections, particularly those viral in origin, are known to be a cause of pancreatitis and in the immunocomprom ised host this occurs more commonly. During the process of renal allograft rejection the antibodies produced against the transplant are known to be reactive against other tissues and it has been suggested that an autoim mune vasculitis of the pancreas may be a result of the rejection process [20].…”

Section: Discussionmentioning

confidence: 99%

Acute Pancreatitis following Renal Transplantation

Salem¹,

Williams²,

Blumgart³

1985

Dig Surg

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Acute pancreatitis occurred in 7 patients 3 days to 8 years after renal transplantation. Three patients had or developed biliary calculi which may have been responsible for the disease and 3 patients had cytomegalovirus infections with rising antibody titres. Two patients had more than 1 attack, 1 patient died and 1 patient, during an episode of acute pancreatitis, suffered rejection of the renal allograft which had to be removed. Aetiology, management and the place of surgery are discussed with reference to 1 patient, in whom interventional radiology successfully avoided the need for further surgery.

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Hyperparathyroidism and Pancreatitis

Cited by 132 publications

References 6 publications

The Association of Primary Hyperparathyroidism With Pancreatitis

The Association of Primary Hyperparathyroidism With Pancreatitis

Primary hyperparathyroidism

Acute Pancreatitis following Renal Transplantation

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