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Pancreatitis in patients with primary hyperparathyroidism.
Amit Agarwal1, Robbie K George, Sushil K Gupta
1Departments of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226 014. amit@sgpgi.ac.in
Summary
Primary hyperparathyroidism (PHPT) is a rare cause of pancreatitis. Successful parathyroidectomy resolves pancreatitis symptoms and prevents future attacks in most patients.
Area of Science:
- Endocrinology
- Gastroenterology
- Surgical Oncology
Background:
- Primary hyperparathyroidism (PHPT) is a metabolic disorder often associated with complications like renal stones and bone disease.
- The link between PHPT and pancreatitis is not well-established, making diagnosis and treatment challenging.
- This study investigates the incidence and outcomes of pancreatitis in patients with PHPT.
Observation:
- A retrospective analysis of 87 patients with PHPT undergoing parathyroidectomy between 1991 and 2003 was conducted.
- Six patients (6.8%) had associated pancreatitis, presenting as the initial symptom in five cases.
- All pancreatitis patients had a history of recurrent attacks, renal stones, and some had bone disease.
Findings:
- Parathyroid adenoma or carcinoma was identified as the cause of PHPT in all affected patients.
- Five patients who underwent successful parathyroidectomy experienced pancreatitis resolution and no recurrence during follow-up.
- One patient with failed parathyroid exploration continued to have pancreatitis attacks, necessitating repeat surgery.
Implications:
- Hyperparathyroidism is a rare but treatable cause of pancreatitis.
- Parathyroidectomy can lead to the resolution of pancreatitis in patients with PHPT.
- Early diagnosis and surgical intervention for PHPT may improve outcomes for patients with pancreatitis.