2013, Number 4
Acute Pancreatitis by Hyperparathyroidism due to Vitamin D3 Deficiency (not-Described Cause)
Monroy-Saint-Martin M, Roldán-Sarmiento P, Murrieta-González H, Mercado M, Halabe-Cherem J
Full text
Language: Spanish
References: 5
Page: 442-444
PDF size: 387.32 Kb.
ABSTRACT
A 53-year-old woman with no medical history of importance with epigastric pain, nausea and fever. Clinical and laboratory examinations diagnosed acute pancreatitis. We sought the cause of acute pancreatitis, discarding the most common causes. Serum calcium remained always within normal limits, which is abnormal in a this diagnosis, and serum levels of vitamin D3 reportedly at low limits. Because of this PTH levels were obtained, which were reported at 277 pg/mL (normal: 17-73 pg/mL). Patient was treated with vitamin D3 for a couple of months and the patient decided to stop treatment and soon alter she presented symptoms of acute pancreatitis once again. Currently the patient takes daily calcitriol, without presenting new crisis of acute pancreatitis. Common causes of acute pancreatitis were sought without finding any. Because normal levels of calcium were present during acute phase of pancreatitis, calcitriol and parathyroid hormone levels were obtained, making the diagnosis of secondary hyperparathyroidism due to calcitriol deficiency. When initiating exogen replacement with vitamin D3 pancreatitis disappeared. Currently the patient takes calcitriol daily without presenting new crisis of acute pancreatitis. We propose to search, among the causes of acute pancreatitis, secondary hyperparathyroidism due to vitamin D3 deficiency, because replacement therapy can reverse the repetitive crisis of acute pancreatitis.REFERENCES