Frequency & predictors of pancreatitis in symptomatic primary hyperparathyroidism

Ashutosh Kumar Arya; Sanjay Kumar Bhadada; Soham Mukherjee; Priyanka Singh; Surinder S Rana; Divya Dahiya; Ashwani Sood; Uma Nahar Saikia; Mahesh Prakash; Deepak Kumar Bhasin; Arunanshu Behera; Rama Walia; Anil Bhansali

doi:10.4103/ijmr.IJMR_353_16

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ORIGINAL ARTICLE

Year : 2018 | Volume : 148 | Issue : 6 | Page : 721-727

Frequency & predictors of pancreatitis in symptomatic primary hyperparathyroidism

Ashutosh Kumar Arya¹, Sanjay Kumar Bhadada¹, Soham Mukherjee¹, Priyanka Singh¹, Surinder S Rana², Divya Dahiya³, Ashwani Sood⁴, Uma Nahar Saikia⁵, Mahesh Prakash⁶, Deepak Kumar Bhasin², Arunanshu Behera³, Rama Walia¹, Anil Bhansali¹
¹ Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
² Department of Gastroenterology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
³ Department of General Surgery, Postgraduate Institute of Medical Education & Research, Chandigarh, India
⁴ Department of Nuclear Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India
⁵ Department of Histopathology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
⁶ Department of Radio Diagnosis & Imaging, Postgraduate Institute of Medical Education & Research, Chandigarh, India

Correspondence Address:
Dr Sanjay Kumar Bhadada
Department of Endocrinology, Nehru Hospital, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/ijmr.IJMR_353_16

Background & objectives: The frequency and predictors of pancreatitis in primary hyperparathyroidism (PHPT) are not well understood. The objective of the present study was to evaluate the frequency of pancreatitis in patients with PHPT and its association with clinical and biochemical parameters of the disease. Methods: In this retrospective study all consecutive patients with PHPT registered in the PHPT registry (www.indianphptregistry.com) from the year 2004 to 2013 were included. The clinical, biochemical and radiological parameters related to pancreatitis were evaluated in histologically proven PHPT patients. Results: A total of 218 patients (63 men; mean age: 40.6±14.4 yr) underwent surgery for PHPT during the study. Pancreatitis occurred in 35 [16%, 18 acute and 17 chronic pancreatitis (CP)] patients and male:female ratio was 1:0.94. Skeletal manifestations were seen less frequently in PHPT with pancreatitis as compared to that of PHPT without pancreatitis. PHPT with pancreatitis had significantly higher serum calcium (12.4±2.0 vs. 11.7±1.5 mg/dl, P <0.05) in comparison to PHPT without pancreatitis. PHPT with acute pancreatitis (AP) had higher serum calcium (P <0.05) and parathyroid hormone (PTH) (P <0.05) levels than PHPT with CP. Curative parathyroidectomy improved the symptoms associated with pancreatitis as there was no recurrence in AP group, whereas recurrence was observed only in about 10 per cent patients of the CP group. Interpretation & conclusions: Pancreatitis was observed in 16 per cent of PHPT patients with male predominance in the study population. No recurrence of AP was observed after curative surgery. It may be proposed that serum amylase with calcium and PTH should be measured in all patients of PHPT with pain abdomen to rule out pancreatitis.

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