Purpose

The true association between primary hyperparathyroidism (PHPT) and pancreatitis continues to be controversial. In this study, we present clinical data, investigative profile, management and follow-up of PHPT patients with pancreatitis and compare this group with PHPT patients without pancreatitis.

Methods

Records of 242 patients with PHPT managed at our center over 24 years were retrospectively analyzed for demographic and laboratory data. The diagnosis of pancreatitis was entertained in the presence of at least two of the three following features: abdominal pain, levels of serum amylase greater than three times the normal or characteristic features at imaging.

Results

Fifteen (6.19%) of the 242 consecutive patients with PHPT had had pancreatitis. Fourteen patients (93.3%) had acute pancreatitis (AP), while one patient had chronic calcific pancreatitis. Over half (8 of 14) of the patients with AP had at least two episodes of pancreatitis. Pancreatitis was the presenting symptom in 14 (93.3%) patients. None of the pancreatitis cases had additional risk factors for pancreatitis. PHPT patients with pancreatitis had significantly higher serum calcium and ALP than PHPT patients without pancreatitis. After successful parathyroidectomy, 14 patients had no further attacks of pancreatitis during a median follow-up of 16 months (range 2–41 months), while recurrence of pancreatitis was seen in one patient.

Conclusions

We conclude that pancreatitis can be the only presenting complaint of PHPT. Our study highlights the importance of fully investigating for PHPT in any pancreatitis patient with high normal or raised serum calcium level, especially in the absence of other common causes of pancreatitis.

中文翻译：

---

原发性甲状旁腺功能亢进症和胰腺炎。

目的

原发性甲状旁腺功能亢进症（PHPT）与胰腺炎之间的真正关联仍存在争议。在这项研究中，我们介绍了患有胰腺炎的PHPT患者的临床数据，研究概况，治疗和随访情况，并将该组与未患有胰腺炎的PHPT患者进行了比较。

方法

我们回顾性分析了24年来我们中心管理的242名PHPT患者的记录，以进行人口统计学和实验室数据分析。在以下三个特征中至少有两个存在时才可以诊断出胰腺炎：腹痛，血清淀粉酶水平大于成像时正常特征的三倍。

结果

连续242例PHPT患者中有15例（6.19％）患有胰腺炎。十四名患者（93.3％）患有急性胰腺炎（AP），而一名患者患有慢性钙化性胰腺炎。超过一半（14人中有8人）的AP患者至少有两次胰腺炎发作。胰腺炎是14例（93.3％）患者的表现症状。没有任何胰腺炎病例具有胰腺炎的其他危险因素。患有胰腺炎的PHPT患者的血清钙和ALP明显高于没有胰腺炎的PHPT患者。甲状旁腺切除术成功后，在中位随访16个月（2-41个月）内，没有14例患者再发胰腺炎，其中1例患者复发。

结论

我们得出结论，胰腺炎可能是PHPT的唯一表现。我们的研究突出了对任何正常或血清钙水平高的胰腺炎患者进行PHPT研究的重要性，特别是在没有其他常见胰腺炎原因的情况下。