Minimally Invasive Parathyroidectomy in a Child With Acute Pancreatitis

Abstract

Acute pancreatitis (AP) is rarely seen in the paediatric population and is typically not associated with those aetiologies seen in adult pancreatitis. This case describes a 12-year-old female who presented with acute abdominal pain and constipation, with biochemical evidence of elevated serum amylase, calcium (Ca) and parathyroid hormone (PTH) levels. A diagnosis of AP was made, which was settled with conservative management. Further investigations, namely CT and technetium 99m (Tc-99m) sestamibi scans, revealed a solitary parathyroid adenoma. She subsequently underwent minimally invasive parathyroidectomy (MIP), following which Ca and PTH levels normalized postoperatively.

Turning Points in Cross-Disciplinary Perspective of Primary Hyperparathyroidism and Pancreas Involvements: Hypercalcemia-Induced Pancreatitis, MEN1 Gene-Related Tumors, and Insulin Resistance

“…Summarizing, in addition to the five previously mentioned cases of pregnancy primary hyperparathyroidism [37][38][39]41,42] and three reports of a parathyroid carcinoma [47][48][49], another seventeen articles introduced one patient per case study, except for two papers with two subjects (a total of nineteen individuals). Four children (aged between 9 and 14 years; an average age of 12; female-to-male ratio of three to one) and fifteen adults (aged between 31 and 81 years; mean age of 51.6 years; female-to-male ratio of two to one) were reported within the last five years in the field of hypercalcemia-derivate pancreatitis in patients with parathyroid NETs (N = 27 individuals) [18,21,22,25,34,35,[53][54][55][56][57][58][59][60][61][62][63] (Table 4). From a cross-disciplinary perspective, the synchronous identification of pancreatitis and primary hyperparathyroidism requires the dual management of pancreatic involvement and hypercalcemia in the sense of rapid calcium lowering, and, when clinically stable, a definite cure of primary hyperparathyroidism should be provided by parathyroidectomy.…”

“…Summarizing, in addition to the five previously mentioned cases of pregnancy primary hyperparathyroidism [ 37 , 38 , 39 , 41 , 42 ] and three reports of a parathyroid carcinoma [ 47 , 48 , 49 ], another seventeen articles introduced one patient per case study, except for two papers with two subjects (a total of nineteen individuals). Four children (aged between 9 and 14 years; an average age of 12; female-to-male ratio of three to one) and fifteen adults (aged between 31 and 81 years; mean age of 51.6 years; female-to-male ratio of two to one) were reported within the last five years in the field of hypercalcemia-derivate pancreatitis in patients with parathyroid NETs (N = 27 individuals) [ 18 , 21 , 22 , 25 , 34 , 35 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ] ( Table 4 ).…”

“…Reported data (case studies) on pancreatitis in patients with PTH-related hypercalcemia during the diagnosis of primary hyperparathyroidism according to our research (the table starts with the most recent publication date)[18,21,22,25,34,35,[53][54][55][56][57][58][59][60][61][62][63].…”