Introduction: Here we describe six cases of primary hyperparathyroidism presenting initially as acute pancreatitis. Further evaluation of our cases not only confirmed primary hyperparathyroidism on the biochemical investigation but also localized the parathyroid adenoma by nuclear imaging.
Discussion: A thorough literature search confirmed that pancreatitis is a rare initial manifestation of primary hyperparathyroidism. We also tried to compare previously published case series of pancreatitis and primary hyperparathyroidism both in India and across the world. Young age, male sex, and presence of normocalcemia or hypercalcemia at diagnosis of pancreatitis need to be further evaluated for primary hyperparathyroidism after initial acute management of pancreatitis.
Conclusion: Though hypercalcemia due to primary hyperparathyroidism is mainly responsible for the development of pancreatitis, the role of other genetic and environmental influences also exists as per multihit hypothesis to manifest as pancreatitis in addition to the main role of hypercalcemia.
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