Şiddetli Hiperkalsemi: Paratiroid Karsinomu ve Akut Pankreatit Olgu Sunumu

Hiperkalsemi; en sık primer hiperparatiroidi ve maligniteye bağlı olarak gelişen, hayatı tehdit eden bir elektrolit bozukluğudur. Hiperkalsemili hastalarda paratiroid hormon düzeyi, hiperkalsemi etiyolojisini saptamada yol gösterici olduğu için ilk bakılması gereken tahlillerdendir. Paratiroid kanseri nadir görülen ve ciddi hiperparatiroidi tablosu ile seyredebilen bir hastalıktır. Hiperkalsemi ve hiperparatiroidi nadiren akut pankreatite yol açabilir. Bu çalışmada, 55 yaşında akut böbrek yetmezliği ve hiperkalsemi nedeni ile kliniğimize yatırılan, takiplerinde akut pankreatit gelişen ve paratiroid karsinomu tanısı konan bir olguyu sunduk.

Severe Hypercalcemia: Parathyroid Carcinoma and Acute Pancreatitis Case Report

Severe Hypercalcemia: Parathyroid Carcinoma and Acute Pancreatitis Case ReportHypercalcemia, mostly caused by primary hyperparathyroidism and malignancy, is a life-threating electrolyte disorder. An initial etiological workup should include measurement of intact parathyroid hormone because of its lodestar role in patients with hypercalcemia. Parathyroid carcinoma is a rarely seen disease but can lead to severe form of hyperparathyroidism. Hypercalcemia and hyperparathyroidism scarcely cause acute pancreatitis. In this study, we report a case of a 55-year old patient admitted to our clinic with acute renal failure and hypercalcemia who developed acute pancreatitis and diagnosed with parathyroid carcinoma.

___

  • 1. Shane E, Irani D. Hypercalcaemia: Pathogenesis, Clinical Manifestations, Differential Diagnosis and Management. In: Favus MJ (Ed). Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, American Society for Bone and Mineral Research, USA, 2006; 176-180.
  • 2. Strewler GJ, Nissenson RA. Hypercalcemia in malignancy. West J Med 1990;153:635-40.
  • 3. Carroll MF, Schade DS. A practical approach to hypercalcemia. Am Fam Physician. 2003; 67: 1959-66.
  • 4. Shane E. Parathyroid carcinoma. J Clin Endocrinol Metab 2001; 86: 485-93.
  • 5. Horwitz MJ, Stewart AF. Hypercalcemia associated with malignancy. In: Primer on the Metabolic Bone Diseases and disorders of Mineral Metabolism, 6th ed, Favus MJ (Ed), American Society of Bone and Mineral Research, Washington, D.C. 2006; 195.
  • 6. Obara T, Fujimoto Y. Diagnosis and treatment of patients with parathyroid carcinoma: an update and review. World J Surg 1991; 15: 738-44.
  • 7. Lee PK, Jarosek SL, Virnig BA, Evasovich M, Tuttle TM. Trends in the incidence and treatment of parathyroid cancer in the United States. Cancer 2007; 109: 1736.
  • 8. Singer MV, Gyr K, Sarles H. Revised classification of pancreatitis: Report of the Second International Symposium on the Classification of Pancreatitis in Marseille, France. Gastroenterology, 1985; 89: 683-5.
  • 9. Karne S, Gorelick FS. Etiopathogenesis of acute pancreatitis. Surg Clin North Am 1999; 79: 699-710.
  • 10. Khoo TK, Vege SS, Abu-Lebdeh HS, Ryu E, Nadeem S, Wermers RA. Acute pancreatitis in primary hyperparathyroidism: a populationbased study. J Clin Endocrinol Metab 2009; 94: 2115-18.
  • 11. Bess MA, Edis AJ, van Heerden JA. Hyperparathyroidism and pancreatitis. Chance or a causal association? JAMA 1980; 243: 246-7.
  • 12. Ward JB, Petersen OH, Jenkins SA, Sutton R. Is an elevated concentration of acinar cytosolic free ionised calcium the trigger for acute pancreatitis? Lancet 1995; 346: 1016-9.