Acute Pancreatitis Unmasking Primary Hyperparathyroidism: A Case Report

Primary hyperparathyroidism (PHPT) is a disorder characterized by increased parathyroid hormone levels, leading to increased serum calcium levels and associated complications. Acute pancreatitis (AP) can occur as an uncommon but serious manifestation of hypercalcemia due to PHPT. The objective of this report was to describe a 56-year-old woman who experienced recurrent AP, eventually revealing hypercalcemic PHPT caused by a parathyroid adenoma.

A 56-year-old woman presented with recurrent episodes of AP. Routine workup for common etiologies was negative. Laboratory findings revealed persistent hypercalcemia, with markedly increased parathyroid hormone levels, leading to a diagnosis of PHPT caused by a parathyroid adenoma. Imaging confirmed the adenoma. Parathyroidectomy was successfully performed, significantly improving her symptoms and normalizing the serum calcium level.

Hypercalcemia-induced AP is rare but serious, often overshadowed by other causes such as gallstones or alcohol. This report also reviews current literature to highlight key considerations in the diagnosis and management of this condition. The case underlines PHPT should be suspected when other common causes of AP are excluded, even if the serum calcium levels are within the normal range or increase. This case underscores the importance of evaluating the serum calcium levels in patients with recurrent or idiopathic AP. Parathyroidectomy remains the definitive treatment, offering symptom resolution and improved outcomes.

PHPT should be suspected in patients presenting with recurrent pancreatitis when common etiologies are excluded. Consequently, assessing serum calcium may be essential in these cases to facilitate timely diagnosis and management of hypercalcemia-related pancreatitis.