Recurrent Acute Pancreatitis in Pregnancy Caused by Parathyroid Hyperplasia: A Case Report and Literature Review

2020 ◽  
Vol 103 (9) ◽  
pp. 952-959
Keyword(s):  
Acute Pancreatitis ◽  
Case Report ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Epigastric Pain ◽  
Present Report ◽  
Parathyroid Hyperplasia ◽  
Pathological Examination ◽  
Recurrent Acute Pancreatitis ◽  
First Case

Background: Hypercalcemia during pregnancy leads to multiple maternal and fetal complications. To date, fewer than 30 cases of primary hyperparathyroidism (PHPT)-induced pancreatitis have been diagnosed during pregnancy. Most cases have been caused by a parathyroid adenoma. In the present report, the author described the first case of PHPT due to parathyroid hyperplasia presented with recurrent, acute pancreatitis during pregnancy. Case Report: A 38-year-old female, with a history of acute pancreatitis during her first pregnancy, presented with severe epigastric pain, nausea, and vomiting for three days at 24 weeks of gestation. Parathyroid-dependent, hypercalcemia-induced recurrence of pancreatitis was diagnosed based on the clinical presentation and laboratory investigations. An ultrasound on her neck revealed a possible parathyroid adenoma located on the inferior pole of the left thyroid gland. She underwent an uneventful left-lower parathyroidectomy. The pathological examination revealed parathyroid hyperplasia. Her serum calcium and parathyroid hormone levels returned to normal after surgery. She delivered a healthy male newborn at gestational age 38 weeks without any complications. Conclusion: PHPT-induced acute pancreatitis during pregnancy is rare. Hypercalcemia, involving both total and ionized calcium, should be investigated in pregnant women who present with acute pancreatitis. Early diagnosis and appropriate management can significantly improve the maternal, fetal, and pregnancy outcomes. Keywords: Hypercalcemia, Recurrent pancreatitis, Pregnancy, Primary hyperparathyroidism, Parathyroid hyperplasia

scholarly journals Primary Hyperparathyroidism due to Parathyroid adenoma presenting as recurrent acute pancreatitis

2017 ◽  
Vol 8 (1) ◽  
pp. 98-100
Author(s):  
Tarun J George ◽  
Pughazhendhi Thangavelu ◽  
S Zahir Hussain ◽  
MP Kumaran ◽  
Kini Ratnakar ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Elevated Serum ◽  
Surgical Excision ◽  
Medical Sciences ◽  
Thyroid Lobe ◽  
Recurrent Acute Pancreatitis ◽  
Hypoechoic Nodule ◽  
Left Thyroid Lobe

Primary hyperparathyroidism (PHPT) due to parathyroid adenoma presenting as recurrent acute pancreatitis is a rare entity. A 17-year-old male presented with recurrent attacks of pancreatitis and was found to have elevated serum calcium and Parathyroid hormone levels, 11.9mg/dL (8.5-10.2 mg/dL) and 396 pg/ml (10-65pg/ml) respectively. USG neck showed a 1.1 x 0.9 cm hypoechoic nodule in the superior aspect of left thyroid lobe. Parathyroid scintigraphy findings were consistent with parathyroid adenoma. After recovery of pancreatitis, surgical excision of the adenoma was done and the histopathological findings confirmed parathyroid adenoma. There were no further recurrence of pancreatitis following the excision.Asian Journal of Medical Sciences Vol.8(1) 2017 98-100

scholarly journals A Case Report on Recurrent Acute Pancreatitis with Primary Hyperparathyroidism

2016 ◽  
Vol 11 (1) ◽  
pp. 36-38
Author(s):  
Mukesh Prasad Sah ◽  
Dewan Saifuddin Ahmed ◽  
Syeda Nur E Jannat ◽  
Md Alamgir Kabir ◽  
Muhammad Rezeul Huq ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Calcium Concentration ◽  
Viral Infections ◽  
Recurrent Acute Pancreatitis ◽  
Common Cause ◽  
Severe Pancreatitis ◽  
Gall Stones ◽  
Common Causes

Pancreatitis is a common non-bacterial inflammatory disease caused by activation, interstitial liberation and auto digestion of pancreas by its own enzymes. Common causes of acute pancreatitis are gall stones, alcohol, drugs, trauma, viral infections and hypertriglyceridemia. Much is known about the causes of pancreatitis but huge experimental data available about understanding of its pathogenesis is still incomplete. Hypercalcemia as a cause of pancreatitis is rarely reported. Hypercalcemia is usually the result of Primary hyperparathyroidism (PHPT) and the most common cause of PHPT is parathyroid adenoma. It is thought that the increased calcium concentration in pancreatic juice resulting from hypercalcemia may prematurely activate proteases. Mutations in different genes have been proposed as well to justify why only some patients with primary hyperparathyroidism and hypercalcemia develop acute pancreatitis. Here we present a case of recurrent acute pancreatitis resulting from hypercalcemia due to parathyroid adenoma in a 38-year-old man. Hyperparathyroidism was suspected when despite severe pancreatitis calcium level remained high and parathormone level was grossly raisedFaridpur Med. Coll. J. Jan 2016;11(1): 36-38

scholarly journals LINAGLIPTIN-INDUCED PANCREATITIS

2020 ◽  
Vol 6 (1) ◽  
pp. e37-e39 ◽  
Author(s):  
Jorge Esteban Mosquera ◽  
Nancy Torres ◽  
Jorge Restrepo ◽  
Carlos Ruz-Pau ◽  
Sowmya Suryanarayanan
Keyword(s):  
Diabetes Mellitus ◽  
Acute Pancreatitis ◽  
Case Report ◽  
Epigastric Pain ◽  
The United States ◽  
Dipeptidyl Peptidase ◽  
Dipeptidyl Peptidase 4 ◽  
First Case ◽  
Dipeptidyl Peptidase 4 Inhibitors

Objective: To report a case of linagliptin-induced acute pancreatitis and remind clinicians about risks with incretin-based drugs. Patients at risk for pancreatitis should be switched to another type of hypoglycemic treatment. Methods: We present the case of a 74-year-old Latina who presented to the emergency department with sudden onset of epigastric pain radiating to her back. Medical history, physical exam, laboratory tests, and medical images were compatible with acute pancreatitis. Upon further investigation, common causes for her pathology were excluded. Ten weeks prior to presentation she had changed her medications for diabetes mellitus type 2 to linagliptin. Results: Using the Naranjo algorithm of adverse drug reactions, we concluded that linagliptin was the most likely culprit. Conclusion: Incretin-based drugs, including dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists, have been shown to be relatively safe for the management of type 2 diabetes mellitus. Since their introduction to the market, conflicting data regarding pancreatic side effects have been published, including a small risk of developing acute pancreatitis with dipeptidyl peptidase-4 inhibitors like sitagliptin and saxagliptin. To date there has been only 1 case report associating linagliptin with acute pancreatitis in the English medical literature. Ours is the first case report in the United States associating linagliptin with acute pancreatitis. It is worth warning both patients and prescribers about this serious adverse effect, as it might affect the choice of antiglycemic agent.

scholarly journals Hypercalcemia induced pancreatitis as a rare presentation of primary hyperparathyroidism

2021 ◽  
Vol 84 (2) ◽  
pp. 367-370
Author(s):  
V Desmedt ◽  
S Desmedt ◽  
E D’heygere ◽  
G Vereecke ◽  
W Van Moerkercke
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Case Report ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Inflammatory Process ◽  
High Morbidity ◽  
Rare Presentation ◽  
Common Cause ◽  
Upper Abdominal

Acute pancreatitis (AP) is an inflammatory process of the pancreas. It is a relatively common cause of acute upper abdominal pain and is potentially associated with high morbidity and mortality. Underlying hypercalcemia as a cause of AP is very rare. We present a case of a hypercalcemia-induced acute pancreatitis with an underlying parathyroid adenoma in an 81-year-old woman with no previous symptoms of hypercalcemia. The parathyroid adenoma was semi-urgently surgically resected with normalization of calcium-levels. This case report summarizes the causes of acute pancreatitis and hypercalcemia and its management.

scholarly journals Severe bone disease caused by primary hyperparathyroidism: a case report and review of the literature

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096648
Author(s):  
Yu Wang ◽  
Jie Liu
Keyword(s):  
Case Report ◽  
Primary Hyperparathyroidism ◽  
Bone Disease ◽  
Distal Humerus ◽  
Left Lobe ◽  
Pathological Examination ◽  
Hypoechoic Mass ◽  
Brown Tumors ◽  
Restricted Mobility ◽  
The Right

Bone disease is an important complication of hyperparathyroidism. We herein report a rare case of severe bone disease caused by primary hyperparathyroidism. A 33-year-old man presented with pain and restricted mobility in his right upper limb and right hip due to a fall 3 days previously. X-ray examination showed a fracture of the proximal and distal humerus. Computed tomography examination showed a supracondylar fracture of the right humerus, a fracture of the right femoral neck, a fracture of the right sciatic branch, and multiple brown tumors. Ultrasonography showed a 3.5- × 1.6-cm hypoechoic mass below the left lobe of the thyroid. The patient was diagnosed with primary hyperparathyroidism based on increased serum calcium and parathormone concentrations, pathological fractures, and multiple brown tumors. He therefore underwent bilateral lower parathyroidectomy. Pathological examination revealed a parathyroid adenoma. The patient recovered well after surgery and was followed up for 6 months with no symptoms of hyperparathyroidism. This case report suggests that clinicians should be aware of the possibility of severe bone disease secondary to primary hyperparathyroidism. Active and early diagnosis and surgical treatment are important in such cases.

Giant parathyroid adenoma diagnosed by brown tumor, a clinical manifestation of primary hyperparathyroidism: a case report

2021 ◽  
pp. 1-8
Author(s):  
Banu Yigit ◽  
Mert Tanal ◽  
Bulent Citgez
Keyword(s):  
Case Report ◽  
Primary Hyperparathyroidism ◽  
Secondary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Benign Lesion ◽  
Brown Tumor ◽  
Skeletal System ◽  
Radiological Findings ◽  
Facial Bones ◽  
Osteitis Fibrosa Cystica

Abstract Brown tumor (BT) is the pathological expression of osteitis fibrosa cystica owing to primary and secondary hyperparathyroidism (HPT). It is a rare benign lesion of skeletal system that usually affects the facial bones, clavicles, ribs, pelvis and extremities. The purpose of this case report is to present the clinical, pathological and radiological findings of BT, rarely seen in adults, originating from the giant parathyroid adenoma and emerging as the first clinical sign of HPT. The patient underwent a successful parathyroidectomy operation and on the first postoperative day, the patient was discharged without any complications. Continuous...

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