Observational Study
Copyright ©The Author(s) 2022.
World J Gastrointest Pharmacol Ther. Jul 5, 2022; 13(4): 47-56
Published online Jul 5, 2022. doi: 10.4292/wjgpt.v13.i4.47
Table 1 Demography, clinical and biochemical profile of all primary hyperparathyroidism patients
Parameters
n = 51
Age (yr)47.80 ± 14.51
Female gender31 (60.78%)
Sex (female: male)1.55:1 (female 31, male 20)
Bone pain28 (54.90%)
Fracture 04 (7.84%)
Pain abdomen22 (43.13%)
Nausea and vomiting16 (31.37%)
Weight loss12 (23.52%)
Fatigue and weakness25 (49.01%)
Anorexia 16 (31.37%)
Psychiatric features06 (11.76%)
Nephrolithiasis 17 (33.33%)
Nephrocalcinosis 11 (21.56%)
Cholelithiasis 04 (7.84%)
Serum creatinine (mg/dL)0.80 (0.63-1.14)
Serum corrected calcium(mg/dL)12.41 ± 1.58
Serum phosphorous (mg/dL)2.7 (2.2-3.17)
Serum magnesium (mg/dL)1.80 (1.7-2)
Serum albumin (g/dL)3.90 (3.5-4.2)
Serum alkaline phosphatase (IU/L)196 (127.5-502)
Serum 25-OH vitamin D (ng/mL)18.09 ± 9.93
Plasma iPTH (pg/mL)328.10 (143-1111)
Table 2 Comparison between primary hyperparathyroidism without pancreatitis and primary hyperparathyroidism with acute pancreatitis
Parameters
PHPT-NP, n = 39
PHPT-AP, n = 05
P value
Age (yr)49.23 ± 14.8035.20 ± 16.110.05
Female gender27 (69.23%)0
Bone pain22 (56.41%)1 (20%)0.17
Fracture 04 (10.26%)0
Pain abdomen10 (25.64%)5 (100%)< 0.01
Nausea and vomiting05 (12.82%)5 (100%)< 0.01
Weight loss06 (15.38%)1 (20%)1
Fatigue and weakness18 (46.15%)2 (40%)1
Anorexia 06(15.38%)4 (80%)< 0.01
Psychiatric features03 (7.69%)0
Nephrolithiasis 14 (35.89%)0
Nephrocalcinosis 09 (23.07%)0
Cholelithiasis 02 (5.12%)1 (20%)0.31
Serum creatinine(mg/dL)0.80 (0.60-1.19)0.74 (0.66-0.89)0.66
Serum corrected calcium(mg/dL)12.46 ± 1.7111.66 ± 1.150.32
Serum phosphorous (mg/dL)2.7 (2.2-3.17)2.7 (2.02-2.90)0.62
Serum magnesium (mg/dL)1.82 ± 0.331.76 ± 0.340.72
Serum albumin (g/dL)3.90 (3.5-4.1)4.2 (3.7-4.75)0.18
Serum ALP (IU/L)242 (148-764.5)112 (106.25-147)0.03
Serum 25-OH vitamin D(ng/mL)15.48 (10.24-21.37)25.91 (13.88-31.72)0.33
Plasma iPTH (pg/mL)519.80(149-1649.55)125 (80.55-178.65)0.01
Table 3 Biochemical and imaging findings of patients with primary hyperparathyroidism with acute pancreatitis
No
Age
Sex
S Amylase (IU/mL)
S lipase (IU/mL)
Imaging
Modified CT severity index
146M160770Acute pancreatitis on CECT 4
227M1487NAAcute interstitial pancreatitis on MRCPNA
320MNANAAcute pancreatitis on CECT6
425M514260Acute necrotizing pancreatitis on CECT6
558M12761365Acute necrotizing pancreatitis on CECT8
Table 4 Rates of pancreatitis among patients with primary hyperparathyroidism in different studies
Ref.
Country
Number of PHPT Patients
PHPT with pancreatitis n (%)
Type of pancreatitis
Bess et al[7]USA115317 (1.5)10 AP (0.86%), 7 CP
Sitges-Serra et al[8]Spain867 (8.1)3 AP (3.4%), 1 RP, 3 CP
Koppelberg et al[9]Germany23413 (5.6)9 AP (3.8%), 4 CP
Shepherd et al[12]Australia1377 (5.1)All AP (5.1%)
Carnaille et al[10]France122440 (3.3)18 AP (1.47), 8 RP, 14 CP
Agarwal et al[32]India876 (6.9)5 RP, 1 CP
Jacob et al[13]India10113 (12.9)6 AP (5.94%), 6 RP, 1 CP
Bhadada et al[29]India599 (15.3)All CP
Khoo et al[33]USA68410 (1.5)All AP (1.5%)
Felderbauer et al[22]Germany1259 57 (4.52)16 AP (1.27%), 15 CP, 26 NA
Arya et al[11]India21835 (16)18 AP (8.25%), 17 CP
Misgar et al[5]India24215 (6.19)14 AP (5.78%), 1 CP
Total5484229 (4.17)111 (2.02) AP