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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2015, Number 3

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Rev Invest Clin 2015; 67 (3)

Decrease in the Prevalence of Pancreatitis Associated with Primary Hyperparathyroidism: Experience at a Tertiary Referral Center

Janka-Zires M, Hernández-Calleros J, Gómez-Pérez FJ, Uscanga-Domínguez LF, Pelaez-Luna MC, Almeda-Valdés P

Language: English
References: 18
Page: 177-181
PDF size: 169.25 Kb.


ABSTRACT

Background: Hypercalcemia is a rare but well recognized cause of acute and chronic pancreatitis. Hypercalcemia-related pancreatitis is mainly caused by primary hyperparathyroidism. The prevalence of pancreatitis in hyperparathyroidism varies worldwide and additional disease-modifying factors may play a role in its development. In 1988 the prevalence of pancreatitis secondary to primary hyperparathyroidism at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), a referral center in Mexico City, was 12.1% (95% CI: 6.7-21). Objective: To describe the current prevalence of pancreatitis secondary to primary hyperparathyroidism at the INCMNSZ. Methods: We reviewed 385 cases of primary hyperparathyroidism seen at the hospital between 1987 and 2012. Results: 26 cases with acute or chronic pancreatitis associated with primary hyperparathyroidism were documented, with a prevalence of 6.7% (95% CI: 4.6-9.7), which was lower than the 12.1% previously reported. In the present study, 20% had a history of alcohol consumption, 10% of gallstones, and 20% of ureteral calculi, compared with the previously reported 32.0, 34.6, and 40.0%, respectively. The average calcium levels were 13.1 and 13.8 mg/dl in the previous and current series, respectively. Conclusions: We found a decrease in the prevalence of pancreatitis associated with primary hyperparathyroidism from 12.1% (95% CI: 6.7-21) to 6.7% (95% CI: 4.6-9.7).


REFERENCES

  1. Etemad B, Whitcomb DC. Chronic pancreatitis: diagnosis, classification, and new genetic developments. Gastroenterology. 2001;120:682-707.

  2. Felderbauer P, Karakas E, Fendrich V, et al. Pancreatitis risk in primary hyperparathyroidism: relation to mutations in the SPINK1 trypsin inhibitor (N34S) and the cystic fibrosis gene. Am J Gastroenterol. 2008;103:368-74.

  3. Agarwal A, George RK, Gupta SK, Mishra SK. Pancreatitis in patients with primary hyperparathyroidism. Indian J Gastroenterol. 2003;22:224-5.

  4. Bess MA, Edis AJ, van Heerden JA. Hyperparathyroidism and pancreatitis. Chance or a causal association? JAMA. 1980;243:246-7.

  5. Koppelberg T, Bartsch D, Printz H, Hasse C, Rothmund M. [Pancreatitis in primary hyperparathyroidism (pHPT) is a complication of advanced pHPT]. Dtsch Med Wochenschr. 1994;119:719-24.

  6. Sutton R, Criddle D, Raraty MG, Tepikin A, Neoptolemos JP, Petersen OH. Signal transduction, calcium and acute pancreatitis. Pancreatology. 2003;3:497-505.

  7. Fernandez Del Castillo C, Cantu-Gonzalez G, Robles-Diaz G, Campuzano M. [Primary hyperparathyroidism and pancreatitis. Evidence for a positive association]. Rev Gastroenterol Mex. 1988;53:61-5.

  8. Bai HX, Giefer M, Patel M, Orabi AI, Husain SZ. The association of primary hyperparathyroidism with pancreatitis. J Clin Gastroenterol. 2012;46:656-61.

  9. Bilezikian JP, Silverberg SJ. Clinical practice. Asymptomatic primary hyperparathyroidism. N Engl J Med. 2004;350:1746-51.

  10. Felderbauer P, Karakas E, Fendrich V, Lebert R, Bartsch DK, Bulut K. Multifactorial genesis of pancreatitis in primary hyperparathyroidism: evidence for “protective” (PRSS2) and “destructive” (CTRC) genetic factors. Exp Clin Endocrinol Diabetes. 2011;119:26-9.

  11. Khoo TK, Vege SS, Abu-Lebdeh HS, Ryu E, Nadeem S, Wermers RA. Acute pancreatitis in primary hyperparathyroidism: a population- based study. J Clin Endocrinol Metab. 2009;94:2115-8.

  12. Narayan SD, Kumar Gupta S, Kumari N, Krishani N, Chand G, Mishra A, et al. Primary hyperparathyroidism presenting as hypercalcemic crisis: Twenty-year experience. Indian J Endocr Metab 2015;19:100-5.

  13. Shah VN, Kumar BS, Bhansali A, et al. Effect of gender, biochemical parameters & parathyroid surgery on gastrointestinal manifestations of symptomatic primary hyperparathyroidism. Indian J Med Res. 2014;139:279-84.

  14. Bhadada SK, Udawat HP, Bhansahi A, Rana SS, Sinha SK, Bhasin DK. Chronic pancreatitis in primary hyperparathyroidism; comparison with alcoholic and idiopathic chronic pancreatitis. J Gastroenterol Hepatol. 2008;23:959-64.

  15. Jacob JJ, John M, Thomas N, et al. Does hyperparathyroidism cause pancreatitis? A South Indian experience and a review of published work. ANZ J Surg. 2006;76:740-4.

  16. Carnaille B, Oudar C, Pattou F, Combemale F, Rocha J, Proye C. Pancreatitis and primary hyperparathyroidism: forty cases. Aust NZ J Surg. 1998;68:117-19.

  17. Shepherd JJ. Hyperparathyroidism presenting as pancreatitis or complicated by postoperative pancreatitis. Aust NZ J Surg. 1996;66:85-7.

  18. Sitges-Serra A, de Lecea C AM, Gores PF, Sutherland DE. Pancreatitis and hyperparathyroidism. Br J Surg. 1998;75:158-60.




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