Delayed diagnosis of primary hyperparathyroidism in a patient with recurrent acute pancreatitis: a case report.
- 1Centre of Geriatrics, Hainan Affiliated Hospital of Hainan Medical University, Hainan General Hospital, Haikou, China.
Abstract
Primary hyperparathyroidism (PHPT) is an uncommon but clinically relevant metabolic condition associated with acute pancreatitis. We report a 32-year-old man with recurrent acute pancreatitis over approximately 4 years in whom coexisting PHPT was eventually recognized. Long-term heavy beer consumption and cholelithiasis represented important competing etiological factors. Although the exact amount and frequency of alcohol consumption could not be reliably quantified from the medical record, the patient had recently stopped drinking before the hospitalization leading to the diagnosis of PHPT. Serial abdominal ultrasonography and computed tomography did not demonstrate choledocholithiasis or biliary duct dilatation, and subsequent follow-up imaging showed no evidence of persistent biliary obstruction. Retrospective review of previous laboratory results revealed recurrent hypercalcemia and hypophosphatemia that had not prompted evaluation of parathyroid function. Subsequent testing demonstrated markedly elevated parathyroid hormone levels, and parathyroid scintigraphy and neck ultrasonography localized a right inferior parathyroid lesion. Right inferior parathyroidectomy was performed, and histopathological examination confirmed a parathyroid adenoma. On postoperative day 1, parathyroid hormone decreased markedly to 1.7 pg/mL, with serum calcium of 2.57 mmol/L. During long-term clinical follow-up, including telephone follow-up at approximately 1 and 2 years after surgery and at the most recent contact, the patient remained in good general condition without recurrent abdominal pain or acute pancreatitis. This case suggests that PHPT should be considered in patients with recurrent pancreatitis and persistent hypercalcemia, even when other potential etiological factors are present.
Related
- Delayed diagnosis leading to severe complications in primary hyperparathyroidism caused by atypical parathyroid tumor
- Primary hyperparathyroidism across the care continuum: gaps in diagnosis, access to surgery, and post-operative care
- Investigating Risk Factors for Delayed Melanoma Recurrence Beyond 5 Years Post-Primary Tumor Diagnosis.
- A Two-Stage Prediction Strategy for Primary Hyperparathyroidism
- Opportunistic computed tomography to identify osteoporosis in primary hyperparathyroidism using sestamibi SPECT/CT scans
BibTeX
@article{zhou2026delayed,
title = {{Delayed diagnosis of primary hyperparathyroidism in a patient with recurrent acute pancreatitis: a case report.}},
author = {Xiaoxin Zhou and Yongji Fan and Fan Jiang},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1928811},
url = {https://europepmc.org/article/MED/42921579},
note = {CC BY},
}
RIS
TY - JOUR
TI - Delayed diagnosis of primary hyperparathyroidism in a patient with recurrent acute pancreatitis: a case report.
AU - Xiaoxin Zhou
AU - Yongji Fan
AU - Fan Jiang
PY - 2026
DA - 2026/10/02
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1928811
UR - https://europepmc.org/article/MED/42921579
AB - Primary hyperparathyroidism (PHPT) is an uncommon but clinically relevant metabolic condition associated with acute pancreatitis. We report a 32-year-old man with recurrent acute pancreatitis over approximately 4 years in whom coexisting PHPT was eventually recognized. Long-term heavy beer consumption and cholelithiasis represented important competing etiological factors. Although the exact amount and frequency of alcohol consumption could not be reliably quantified from the medical record, the patient had recently stopped drinking before the hospitalization leading to the diagnosis of PHPT. Serial abdominal ultrasonography and computed tomography did not demonstrate choledocholithiasis or biliary duct dilatation, and subsequent follow-up imaging showed no evidence of persistent biliary obstruction. Retrospective review of previous laboratory results revealed recurrent hypercalcemia and hypophosphatemia that had not prompted evaluation of parathyroid function. Subsequent testing demonstrated markedly elevated parathyroid hormone levels, and parathyroid scintigraphy and neck ultrasonography localized a right inferior parathyroid lesion. Right inferior parathyroidectomy was performed, and histopathological examination confirmed a parathyroid adenoma. On postoperative day 1, parathyroid hormone decreased markedly to 1.7 pg/mL, with serum calcium of 2.57 mmol/L. During long-term clinical follow-up, including telephone follow-up at approximately 1 and 2 years after surgery and at the most recent contact, the patient remained in good general condition without recurrent abdominal pain or acute pancreatitis. This case suggests that PHPT should be considered in patients with recurrent pancreatitis and persistent hypercalcemia, even when other potential etiological factors are present.
SN - 2296-858X
ER -