Pancreatitis in patients with primary hyperparathyroidism

Abstract

Objective To investigate the clinical characters of pancreatitis in patients with primary hyperparathyroidism (PHPT). Methods The clinical data of patients with PHPT undergoing parathyroidectomy from Jan. 2009 to May. 2014 in Peking Union Medical College Hospital were retrospectively analyzed for coexistent pancreatitis. Results 571 patients received parathyroidectomy due to PHPT during this period. Thirteen patients (2.3%)with PHPT were confirmed with coexistent pancreatitis by clinical manifestation and abdominal imaging evaluation, including acute pancreatitis in 9 patients and chronic pancreatitis in 4 patients. PHPT with pancreatitis was associated with preoperative serum intact parathyroid hormone (iPTH) higher than 500 pg/ml (P=0.025) and occurrence of hypercalcemic crisis (P=0.013). The age and sex of patients, preoperative serum calcium, gallstones, urinary calculi and bone fracture were not related with pancreatitis in this group. The average follow-up period for these patients was 34 (ranging from 13 to 68) months. All patients were free from hyperparathyroidism recurrence. Only one young lady with chronic pancreatitis suffered from repeated pancreatitis after surgery. Conclusions Serum iPTH higher than 500 pg/ml and occurrence of hypercalcemic crisis were possible risk factor of pancreatitis in patients with PHPT. Parathyroidectomy can help to prevent the recurrence of pancreatitis in these patients. Key words: Hyperparathyroidism; Pancreatitis; Parathyroid hormone; Hypercalcemic crisis