Primary hyperparathyroidism and pancreatitis

Frequently a causal relationship between hyperparathyroidism (HPT) and pancreatitis has been defended. Bess et al. queried the existence of any causality. A series of 686 patients with surgically confirmed primary hyperparathyroidism (PHPT) was analysed with a coincidence of pancreatitis of 1.5% (n = 10). Three patients had an attack immediately after exploration of the neck, which is more than one would expect after a non-related operation. Although these data are not conclusive, a causal relationship cannot be excluded. It is uncertain whether a parathyrotoxic crisis due to surgical manipulation plays a part. In 27 patients a partial or total thyroidectomy was performed at the time of the parathyroidectomy. None of these patients had a postoperative pancreatitis, which means that in this series the recently postulated protective role of calcitonin cannot be confirmed.