Hypercalcemia – An enigmatic cause of acute pancreatitis
Background: Acute Pancreatitis continues to be one of the common abdominal emergencies encountered in tertiary care hospitals. The majority of acute pancreatitis is caused by gall stones and alcohol. Hypercalcemia though uncommon has been reported to cause acute pancreatitis, recurrent acute pancreatitis, and chronic pancreatitis.
Aim: To describe hypercalcemia-induced acute pancreatitis in different settings.
Methods: In total 100 patients with acute pancreatitis, admitted from January 2021 to December 2021 at our centre, etiologies were biliary (36%), alcohol (19%), idiopathic (21%), alcohol plus Biliary (5%), post endoscopic retrograde cholangio-pancreaticography (7%), drug-induced (6%), hypercalcemia (3%) and dengue infection (3%). Overall mortality was 11%.
Results: In 3 patients with hypercalcemia-induced pancreatitis, causes of hypercalcemia were multiple myeloma, parathyroid adenoma leading to hyperparathyroidism, and hypervitaminosis D in association with hyperthyroidism.
Conclusion: Hypercalcemia-induced acute pancreatitis is not a rare phenomenon and should be actively investigated to prevent further attacks of acute pancreatitis and progression to chronic pancreatitis.
Relevance for patients: Hypercalcemia is a potentially treatable cause of acute pancreatitis and its identification will not only help to treat and prevent further episodes of pancreatitis but also to manage underlying diseases leading to hypercalcemia.
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