Perforated gastric ulcer as the initial manifestation of hyperparathyroidism

Castle, Cameron; Tietjens, James

doi:10.1136/bcr-2020-240570

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…A rare but clinically important manifestation of hypercalcemia is the development of a PUD. It is reported that up to 12% of patients with primary hyperparathyroidism have peptic ulcer-related symptoms [ 12 , 16 , 17 ]. The mechanism of how hypercalcemia leads to PUD is not well established, but several studies back the notion that excess calcium activates the stomach calcium-sensing receptor located on the basolateral membrane of gastric parietal cells, which in turn increases gastric acid secretion [ 12 , 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

A Rare Manifestation of Unknown Hyperparathyroidism as a Perforated Peptic Ulcer

Mlawa¹,

Khan²,

Azhar³

et al. 2023

Cureus

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Hypercalcemia is a common electrolyte abnormality with different causes. Hypercalcemia is most often associated with malignancy and primary hyperparathyroidism and malignancy together account for most cases. Primary hyperparathyroidism manifests as hypercalcemia owing to the overproduction of parathyroid hormone. In most cases, primary hyperparathyroidism manifests due to a solitary parathyroid adenoma. Based on calcium levels, hypercalcemia can be classified as mild, moderate, and severe. Hypercalcemia typically presents with non-specific clinical features. Here, we present the case of a 38-yearold male patient who presented to the emergency department (ED) with acute abdominal pain and a tender abdomen with absent bowel sounds. He had chest radiography and blood tests initially. Chest radiography showed left-sided pneumoperitoneum, and the patient was suspected to have a perforated peptic ulcer due to hypercalcemia secondary to a parathyroid adenoma during the second wave of the coronavirus disease 2019 (COVID-19) pandemic. The findings were confirmed by a computerized tomography scan of the abdomen, and the patient was treated with intravenous fluids for hypercalcemia and was managed conservatively for a sealed perforated peptic ulcer following discussion in the multi-disciplinary team meeting (MDT). The COVID-19 pandemic led to a long waiting list and delays in the timely management of patients requiring elective surgical intervention, such as parathyroidectomy. The patient made a complete recovery and had parathyroidectomy of the inferior right lobe two months later.

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Section: Discussionmentioning

confidence: 99%

A Rare Manifestation of Unknown Hyperparathyroidism as a Perforated Peptic Ulcer

Mlawa¹,

Khan²,

Azhar³

et al. 2023

Cureus

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“…Over time, persistent hypercalcemia can contribute to kidney damage and decreased kidney function [ 94 ]. In the digestive system, excessive calcium can cause constipation and, in some cases, might contribute to the development of stomach ulcers or gallstones [ 95 ]. Neurologically, high calcium levels can result in fatigue, lethargy, and, in severe cases, confusion or even coma [ 96 , 97 ].…”

Section: Essential Metals In Foodmentioning

confidence: 99%

Metals on the Menu—Analyzing the Presence, Importance, and Consequences

Milanković,

Tasić,

Leskovac

et al. 2024

Foods

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Metals are integral components of the natural environment, and their presence in the food supply is inevitable and complex. While essential metals such as sodium, potassium, magnesium, calcium, iron, zinc, and copper are crucial for various physiological functions and must be consumed through the diet, others, like lead, mercury, and cadmium, are toxic even at low concentrations and pose serious health risks. This study comprehensively analyzes the presence, importance, and consequences of metals in the food chain. We explore the pathways through which metals enter the food supply, their distribution across different food types, and the associated health implications. By examining current regulatory standards for maximum allowable levels of various metals, we highlight the importance of ensuring food safety and protecting public health. Furthermore, this research underscores the need for continuous monitoring and management of metal content in food, especially as global agricultural and food production practices evolve. Our findings aim to inform dietary recommendations, food fortification strategies, and regulatory policies, ultimately contributing to safer and more nutritionally balanced diets.

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“…В связи с тем, что достоверно не установлена взаимосвязь между двумя данными заболеваниями, неясен и возможный патогенез формирования язв желудка и двенадцатиперстной кишки при гиперпаратиреозе. Предположительно, основным звеном является повышение уровня кальция, что активирует продукцию гастрина и, в свою очередь, приводит к формированию язв желудка и двенадцатиперстной кишки [26].…”

Section: околощитовидные железыunclassified

The relationship of endocrine and gastroenterological pathology: dietary fiber as a mechanism of management

Teplova,

Demidova,

Lobanova

2023

jour

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Gastroenterological manifestations of endocrine diseases are an additional factor that reduces the quality of life of patients. In some cases, gastroenterological symptoms are the reason for the patient’s coming to the doctor and the detection of endocrine disease. The pathogenetic aspects of the development of disorders of the gastrointestinal tract are diverse, and therefore, unfortunately, it is not always possible to eliminate gastroenterological symptoms by only compensating the underlying disease. The combination of pathology of the gastrointestinal tract and the endocrine system can mutually aggravate the course of each other. There are also cases when gastroenterological pathology can be the root cause of some metabolic diseases, in particular, malabsorption. Currently, the possibilities of correction of gastroenterological pathology are widely studied in order to achieve compensation for the patient’s endocrine pathology, as well as to improve the quality of life of patients. The main directions are measures aimed at restoring the passage of food contents, maintaining the integrity of the intestinal wall, eliminating the inflammatory factor, as well as restoring the gu microbiota (GM) and modulating its metabolism. The latter method of correcting violations seems to be the most promising today due to the constantly growing number of scientific publications, as well as a wide range of safe and effective ways to influence GM. In addition to dietary recommendations, the issue of prescribing dietary fiber (DF) to patients as a food substrate for GM and a mechanism for controlling the number and ratio of microorganisms is becoming increasingly relevant.

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Perforated gastric ulcer as the initial manifestation of hyperparathyroidism

Cited by 3 publications

References 10 publications

A Rare Manifestation of Unknown Hyperparathyroidism as a Perforated Peptic Ulcer

A Rare Manifestation of Unknown Hyperparathyroidism as a Perforated Peptic Ulcer

Metals on the Menu—Analyzing the Presence, Importance, and Consequences

The relationship of endocrine and gastroenterological pathology: dietary fiber as a mechanism of management

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