Primary Hyperparathyroidism Presenting as Pancreatitis: A Retrospective Study in India

Abstract

Aim: To study the association between primary hyperparathyroidism and acute or chronic pancreatitis. Methods: Case records of all the patients underwent surgical treatment for Primary hyperparathyroidism (PHPT) during the period April 2015 to March 2020 were analysed. Clinical presentation, biochemical investigations, imaging studies and outcome of surgery were studied in detail. A total of 54 patients diagnosed to have PHPT underwent parathyroid adenoma excision during 5 years period (2015 – 2020).  Abdominal pain, elevated serum amylase and lipase by 3 times of normal, radiological features of pancreatitis were taken as parameters to diagnose pancreatitis. Out of the 54 patients, 8 patients (14.8%) were presented only with pancreatitis. None of the patient had any other risk factor for pancreatitis. All 8 patients underwent parathyroidectomy. Seven patients had single parathyroid adenoma and one patient had two adenomas. After successful parathyroidectomy none of the patient had recurrence of pancreatitis during a follow up period of 6-42 months. Conclusion: Incidence of pancreatitis in PHPT is 14.8%, which is significantly high compared to western studies. Presence of hypercalcemia during pancreatitis needs further evaluation to rule out hyperparathyroidism especially in the absence of any other risk factor for pancreatitis.