Hyperparathyroid crisis and acute necrotizing pancreatitis presenting as diabetic ketoacidosis

The case history of a patient who presented with diabetic ketoacidosis and was subsequently found to have hyperparathyroid crisis complicated by acute necrotizing pancreatitis and phosphate depletion syndrome is reviewed. The interaction of these diseases and their treatment is discussed. The simultaneous presentation of hyperparathyroid crisis and acute necrotizing pancreatitis is rare, and no instance of survival has been reported previously.