ECEESPE2025 ePoster Presentations Environmental Endocrinology (23 abstracts)
Primary hyperparathyroidism and pancreatitis: a rare and multifaceted association
Jaweher Kechiche 1 , Taieb Ach 2 , Abir Meherzi 1 , Mouna Bellakhdher 1 , Ghada Saad 2 , Jihen Houas 1 , Malika El Omri 1 , Wassin Kermani 1 , Yosra Hasni El Abed 2 & Mohamed Abdelkefi 1
1Farhat Hached University Hospital, ENT Head and Neck Surgery, Sousse, Tunisia; 2Farhat Hached University Hospital, Endocrinology Departement, Sousse, Tunisia
JOINT3594
Introduction: The relationship between primary hyperparathyroidism and acute or chronic pancreatitis remains controversial it has been debated for decades. Hypercalcemia secondary to parathyroid hormone secretion plays a key role in the pathogenesis, although other mechanisms may also be involved. The aim of this study is to assess the prevalence, clinical presentation, and outcomes of pancreatitis associated with PHPT, emphasizing the importance of early diagnosis and management.
Materials and methods: This is a retrospective and descriptive study from January 2010 to December 2023, including all patients admitted and treated for primary hyperparathyoidism associated with pancreatitis
Results: During the study period, 80 patients were hosaitlized for primary hyperparathyroidism. Among them, 3 patients has pancreatitis revealing the disease (3.75%) with 1 recurrent acute panreatitis and 2 chronic calcifying pancreatitis. The male to female ration was ½ with mean age 57 years (54-59 years). 2 patients were diabetics. Revealing clinical symptoms were abdominal pain in all cases associated with vomiting in 1 case. Serum amylase and lipase levels were elevated. Abdominal CT scans were performed for all patients, revealing acute pancreatitis (Balthazar stage C) in one case and chronic calcifying pancreatitis in two cases. Serum calcium levels were elevated in all cases, with an average of 3.35 mmol/l(range: 2.9-3,86mmol/l). The diagnosis of PHPT was confirmed by elevated PTH levels in all cases, with a mean value of 799 pg/mL (range: 197–1920 pg/mL). Parathyroid SPECT with 99m Technetium-MIBI and ultrasound were performed for all patients, identifying a right inferior parathyroid adenoma in two cases and a left inferior parathyroid adenoma in one case. PHPT was diagnosed, and surgical treatment was planned. Surgical resection of the parathyroid adenoma was performed. The outcome was favorable in all three operated patients, with normalization of PTH and serum calcium levels. However, one patient with chronic pancreatitis experienced recurrent episodes of pancreatitis despite successful parathyroidectomy.
Conclusions: The occurrence of pancreatitis during a hyperparathyroidism is rare but it can be the only pesenting symptoms of primary hyperparathyroidism. elevated calcemia during acute or chronic pancreatitis should always get attention.
Volume 110
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Endocrine Abstracts
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