The association of primary hyperparathyroidism with pancreatitis (2023)

FAQs

The association of primary hyperparathyroidism with pancreatitis? ›

The causes of pancreatitis are largely dominated by gallstones and alcohol. Primary hyperparathyroidism (PHPT) is rarely associated with the development of pancreatitis. It is considered as well a cause of acute or chronic pancreatitis (AP or CP).

One explanation is that hypercalcemia from PHPT leads to de novo activation of trypsinogen to trypsin, resulting in autodigestion of the pancreas and subsequent pancreatitis (13).

Acute pancreatitis due to primary hyperparathyroidism (PHPT) is an uncommon condition. Parathyroid carcinoma is a rare cause of PHPT, accounting for <1% of all cases of PHPT. Parathyroid carcinoma is generally associated with an indolent and slowly progressive course.

Among the multitudinous etiologies of pancreatitis, primary hyperparathyroidism (PHPT) is rarely associated with pancreatitis. However, the cause and effect relationship between the two still evokes controversy. We aimed to study and characterize the nature of pancreatic disease in PHPT.

In primary hyperparathyroidism, one or more of the parathyroid glands is overactive. As a result, the gland makes too much parathyroid hormone (PTH). Too much PTH causes calcium levels in your blood to rise too high, which can lead to health problems such as bone thinning and kidney stones.

Primary hyperparathyroidism

A noncancerous growth (adenoma) on a gland is the most common cause. Enlargement (hyperplasia) of two or more parathyroid glands accounts for most other cases. A cancerous tumor is a very rare cause of primary hyperparathyroidism.

Causes of primary hyperparathyroidism include: A noncancerous (benign) growth, called an adenoma, forms on a single parathyroid gland. The adenoma causes the gland to overact and make more PTH. This is the most common cause.

The calcium concentration in pancreatic juice is lower than in plasma. It decreases with high flow rates and increases asymptotically to plasma concentration with low rates. In chronic pancreatitis calcium concentration is raised in the secretin-stimulated juice.

It is postulated that hypercalcemia leads to accelerated intrapancreatic conversion of trypsinogen to trypsin, which causes the pancreatic damage [5].

Usually, acute elevations of calcium can cause pancreatitis. The mechanism causing hypercalcemic pancreatitis may be calcium deposition in the pancreatic duct and calcium activation of trypsinogen in the pancreas.

How does hyperparathyroidism affect pancreas? ›

Primary hyperparathyroidism (PHPT) is rarely associated with the development of pancreatitis. It is considered as well a cause of acute or chronic pancreatitis (AP or CP). Hypercalcemia secondary to the secretion of parathyroid hormone (PTH) plays a major role in the pathogenesis, but other mechanisms may be involved.

The occurrence of pancreatitis during a hyperparathyroidism is rare. Normal or higher calcemia during acute or chronic pancreatitis should always draw attention and be subject to complementary explorations in search of endocrine or malignant cause.

In primary hyperparathyroidism, after successful surgery to remove the parathyroid glands (parathyroidectomy), the outlook (prognosis) is usually excellent and most people are cured. If you do not have symptoms and are followed up without surgery, there is also generally a good prognosis.

If it is determined that you suffer from hyperparathyroid disease and you have parathyroid surgery, it is important that you take calcium and vitamin D supplements to help replenish your calcium stores in your bones.

Treatment options for primary hyperparathyroidism can include watchful waiting, surgery and medications.

The most common symptoms of hyperparathyroidism are chronic fatigue, body aches, difficulty sleeping, bone pain, memory loss, poor concentration, depression, and headaches. Parathyroid disease also frequently leads to osteoporosis, kidney stones, hypertension, cardiac arrhythmias, and kidney failure.

Hyperparathyroidism (HPT) cannot be cured naturally. This is because HPT can be attributed to a set of genetic mutations that results in the abnormal parathyroid gland thinking that a higher calcium level is appropriate for the body (almost like changing the thermostat on your air conditioning).

Primary hyperparathyroidism (PHPT) is often found on routine blood tests, at a relatively asymptomatic stage. However many studies suggest different systemic effects related to PHPT, which could be enhanced by an abnormal cortisol release due to chronic stress of hyperparathyroidism.

Hyperparathyroidism causes smooth-muscle atony, with upper and lower gastrointestinal symptoms such as nausea, heartburn and constipation.

EUS-guided celiac plexus block (CPB) or celiac plexus neurolysis (CPN) is used to reduce the extremely disabling pain associated with chronic pancreatitis or pancreatic cancer. CPB is a temporizing treatment, most commonly injection of a local anesthetic together with a corticosteroid.

What does the pancreas have to do with calcium? ›

Calcium plays a central role in the pathogenesis of pancreatitis and our understanding in this field is still evolving. Calcium is required for normal secretory function of the pancreatic acinar cells, but these signals are transient and mainly confined to apical pole.

Acute pancreatitis is usually caused by gallstones or drinking too much alcohol, but sometimes no cause can be identified.

Autoimmune Pancreatitis

AIP can occur by itself or in association with other autoimmune diseases such as primary sclerosing cholangitis (PSC), primary biliary cirrhosis, retroperitoneal fibrosis, rheumatoid arthritis, sarcoidosis, and Sjögren's syndrome.

Long-term alcohol misuse is responsible for around 7 out of every 10 cases of chronic pancreatitis. This is because heavy drinking over a number of years can repeatedly damage the pancreas. Less common causes include: smoking.

When patients with acute pancreatitis are found to have no obvious causes and elevated serum calcium is observed, PHPT-induced pancreatitis should be suspected. The treatment of hypercalcemia includes hydration with saline, forced diuresis, bisphosphonates, calcitonin, oral phosphates, glucocorticoids, and dialysis.

Too much calcium in your blood can weaken your bones, create kidney stones, and interfere with how your heart and brain work. Hypercalcemia is usually a result of overactive parathyroid glands. These four tiny glands are situated in the neck, near the thyroid gland.

In very severe cases of hyperparathyroidism, high calcium levels can lead to rapid kidney failure, loss of consciousness, coma, or serious life-threatening heart rhythm abnormalities.

Primary hyperparathyroidism mainly affects the skeleton and the kidneys, but the heart, gastrointestinal, and nervous system can sometimes be involved. About 80-85% of the time, the disorder is caused by a benign tumor called an adenoma that is usually found in one of the four parathyroid glands.

Symptoms of hyperparathyroidism

General aches and pains. Stomach pain. Frequent heartburn. (The high calcium level in your blood can cause your stomach to make too much acid.)

Which patient is most likely to develop pancreatitis? ›

Who is affected? Acute pancreatitis is more common in middle-aged and elderly people, but it can affect people of any age. Men are more likely to develop alcohol-related pancreatitis, while women are more likely to develop it as a result of gallstones.

Chronic pancreatitis is often seen with heavy alcohol use and smoking.

Hyperparathyroidism can cause serious health problems if left untreated. These problems include osteoporosis, cardiovascular disease, stroke and kidney disease.

Parathyroid cancer is a rare condition. It occurs in only about 1 percent of people with primary hyperparathyroidism. If doctors believe a tumor is cancerous, the tumor is removed, often with part of the thyroid gland and surrounding lymph nodes.

All patients with symptomatic pHPT are recommended surgery.

Surgery to remove the enlarged gland(s) is the only treatment for hyperparathyroidism (HPT) and cures 95 percent of cases. The growth typically does not return and symptoms disappear after the first month of surgery.

Therefore, high doses of caffeine intake may inhibit pulsatile secretion of PTH. In the parathyroid cell, [Ca²⁺]_i is a central player for PTH secretion, in which high levels of [Ca²⁺]_i result in reduced secretion of PTH.

A daily multivitamin, containing the antioxidant vitamins A, C, E, the B-complex vitamins and trace minerals, such as magnesium, calcium, zinc, and selenium. Calcium citrate, 500 to 1,000 mg daily, for bone support. Vitamin D, 1,000 to 3,000 IU daily, for immunity.

Parathyroid Surgery: The Standard Technique. Hyperparathyroidism, a parathyroid disease, can be cured with surgery. Here's what to expect. Since 1925, the gold standard treatment for primary hyperparathyroidism has been to surgically remove the parathyroid gland (or glands) that are overproducing hormone.

What foods should hyperparathyroidism avoid? ›

Avoid refined foods, such as white breads, pastas, and sugar. Use healthy cooking oils, such as olive oil or coconut oil. Reduce or eliminate trans-fatty acids, found in commercially-baked goods, such as cookies, crackers, cakes, and donuts, French fries, onion rings, processed foods, and margarine.

This indicates that patients with primary hyperparathyroidism had an increased weight or BMI in contrast to other patients. Comparatively, in a study published by Medical Hypotheses, researchers found that body weight was elevated in elderly patients dealing with primary and secondary hyperparathyroidism.

Most often, the cause is a benign tumor of the parathyroid glands (parathyroid adenoma). These benign tumors are common and happen without a known cause. The disease is most common in people over age 60, but it can also occur in younger adults. Hyperparathyroidism in childhood is very unusual.

Mental disturbances are found in more than 50% of patients with hyperparathyroidism. The mental disturbances consist of slight or severe neurasthenic personality change, principally characterized by lack of initiative and depression, and acute organic psychosis in the most severe cases.

It is postulated that hypercalcemia leads to accelerated intrapancreatic conversion of trypsinogen to trypsin, which causes the pancreatic damage [5].

The mechanism causing hypercalcemic pancreatitis may be calcium deposition in the pancreatic duct and calcium activation of trypsinogen in the pancreas. Prompt resolution of pancreatitis occurs after treatment with glucocorticoids.

Hypercalcemia is one of the causes of acute pancreatitis. Frick et al. in a study on rat model reported that hypercalcemia induces pancreatitis by causing secretory block and accumulation of secretory proteins.

Hypercalcemia can cause acute pancreatitis, with a reported prevalence of 1.5-8%,⁵ but is mostly related to hyperparathyroidism. However, rare cases are caused by secondary hypercalcemia due to malignant disease and so on.

Pancreatic calcification is a diagnostic feature of chronic pancreatitis even in the absence of the clinical signs and symptoms. Pancreatic calcification is seen on radiographs in about 30-50% of patients with chronic pancreatitis in adults.

What is the role of calcium in pancreatic secretion? ›

Calcium (Ca²⁺) is a versatile carrier of signals regulating many aspects of cellular activity and plays a central role in controlling digestive enzyme secretion in pancreatic acinar cells.

Patients with gallstones in the opening of their pancreas (the pancreatic duct) may benefit from endoscopic surgery and a treatment called lithotripsy. Lithotripsy involves using shock waves to break the stones into smaller pieces. An endoscope is then used to access the pancreatic duct so the pieces can be removed.

Hypercalcemia is usually a result of overactive parathyroid glands. These four tiny glands are situated in the neck, near the thyroid gland. Other causes of hypercalcemia include cancer, certain other medical disorders, some medications, and taking too much of calcium and vitamin D supplements.