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Iatrogenic acute pancreatitis due to hypercalcemia in a child with pseudohypoparathyroidism

Francesca Feyles, Alessandro Mussa, Valentina Peiretti

    Journal of Pediatric Endocrinology & Metabolism : JPEM
    |August 13, 2013
    PubMed

    Insights

    Hypercalcemia, often caused by vitamin D and calcium overtreatment, can lead to acute pancreatitis in children. This rare condition highlights the need to consider high calcium levels as a potential cause of pancreatitis in pediatric cases.

    Area of Science:

    • Pediatric Endocrinology
    • Gastroenterology

    Background:

    • Pancreatitis in children is uncommon, and its association with hypercalcemia is rare and debated.
    • Pseudohypoparathyroidism (PHP) is a condition involving parathormone (PTH) resistance, leading to hypocalcemia that requires calcium and vitamin D treatment.

    Purpose of the Study:

    • To report a rare case of acute pancreatitis in a child secondary to hypercalcemia.
    • To discuss the potential pathogenetic role of hypercalcemia in pediatric pancreatitis.

    Main Methods:

    • Case report of a 6-year-old boy with pseudohypoparathyroidism.
    • Clinical presentation, laboratory findings (amylase, lipase, calcium), and treatment review.

    Main Results:

    • The patient presented with severe abdominal pain and vomiting, with elevated amylase, lipase, and calcium levels.
    • Hypercalcemia, likely due to overtreatment with calcium and vitamin D for pseudohypoparathyroidism, was implicated as the cause of acute pancreatitis.

    Conclusions:

    • Hypercalcemia, even in the context of treated pseudohypoparathyroidism, should be considered a potential cause of acute pancreatitis in children.
    • Further research is needed to elucidate the mechanisms linking hypercalcemia to pancreatitis and to define the role of predisposing factors.

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