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Acute pancreatitis induced by hypecalcemiahypercalcemia due to primary hyperparathyroidism (PHPT) is a very rare condition, with the , and its prevalence is estimated to be between estimated to be between 1.5% and and 7%. Previous Sstudies conductedfrom in India report an the incidence of PHPT between to be between 6.8% and 12%. However, in patients with PHPT and resulting hypercalcemia, experience pancreatitis occurs 10 to 20-fold times more often often thanthan in the general population. The metabolic causes of acute pancreatitis include diabetic ketoacidosis, hypertriglyceridemia, and hypercalcemia with or without hyperparathyroidism. Normally, hHypocalcemia is expected generally occurs during an attack of acute pancreatitis ; thus,  1  and hypercalcemia is a strong clue predictor for suspecting PHPT. Hence, findings of elevated serum calcium levels associated with pancreatitis should alert the physician to either be indicative of hyperparathyroidism or malignancy. The metabolic causes of acute pancreatitis include diabetic ketoacidosis, hypertriglyceridemia, and hypercalcemia with or without hyperparathyroidism.  2  style='color:blue'>The most common etiologies of pancreatitis are gGallstones and alcoholism. are the commonest etiological agents of pancreatitis. Serum calcium level is not routinely measured in all patients diagnosed with the a first attack of acute pancreatitis as it is not the a common causeetiology. Some patients suffer from 2two or more attack attacks  3  of pancreatitis before the being diagnosed withdiagnosis of PHPT. Here Wwe describe the case of a 30-year-old female patient who presented to a gastroenterology unit with severe upper abdominal pain, vomiting, and a 3-day history of fever of 3 days’ duration. She had experienced a similar episode ofsimilar symptoms  4  2 months previously, for which she was admitted to a civil hospital and diagnosed , where she was diagnosed as with case of acute pancreatitis. There, she was and was managed conservatively and discharged after 7 days. She had noNo additional risk factors causing acute pancreatitis such ashistory of alcohol consumption, or hyperlipidemia, and gallstones were present.; however, Sshe had a history of undergone cholecystectomy 1.5 years earlier for gallstones. After proper evaluation, a she was diagnosed with diagnosis of post-cholecystectomy acute pancreatitis was made, a and the patient was managed conservatively. However, she was readmitted Wwithin the next 5 months, she was again admitted with after experiencing dyspeptic symptoms and abdominal pain pain in abdomen overof 20 days’ duration. On physical examination, the abdomen was found to be soft with diffuse tenderness, especially particularly in the right hypochondrium.

Explanations

Acute pancreatitis induced by hypecalcemiahypercalcemia due to primary hyperparathyroidism (PHPT) is a very rare condition, and its prevalence is estimated to be between 1.5% and 7%. Previous Sstudies conducted in from India report an the incidence of PHPT to be between 6.8% and 12%. However, in patients with PHPT and resulting hypercalcemia, experience pancreatitis occurs 10 to 20 times more often thanthan in the general population. Normally, hHypocalcemia is generally expected to occur during an attack of acute pancreatitis ; thus,  1  and hypercalcemia is a strong clue predictor for suspecting PHPT. Hence, elevated serum calcium levels associated with pancreatitis should alert the physician to either to suspect hyperparathyroidism or malignancy. The metabolic causes of acute pancreatitis include diabetic ketoacidosis, hypertriglyceridemia, and hypercalcemia with or without hyperparathyroidism. The most common etiologies of pancreatitis are gGallstones and alcoholism are the commonest etiological agents of pancreatitis. Serum calcium level is not routinely measured in all patients diagnosed with the a first attack of acute pancreatitis as it is not the a common causeetiology. Some patients suffer from 2two or more attack attacks  2 of pancreatitis before the diagnosis of being diagnosed with PHPT. Here Wwe describe the case of a 30-year-old female patient who presented to a gastroenterology unit with severe upper abdominal pain, vomiting, and a 3-day history of fever of 3 days’ duration. She had a similar episode ofsimilar  4  symptoms 2 months previously, for which she was admitted to a civil hospital and diagnosed , where she was diagnosed as with case of acute pancreatitis. There, she was and was managed conservatively and discharged after 7 days. She had noNo additional risk factors causing acute pancreatitis such as history of alcohol consumption, or hyperlipidemia,; however, she had a history ofand gallstones were present. for which sheShe had a history of undergone cholecystectomy 1.5 years earlier for stone. Therefore, Aafter proper evaluation, a she was diagnosed with diagnosis of post-cholecystectomy acute pancreatitis was made, a and the patient was managed conservatively. Within the next 5 months, she was again readmitted with after experiencing dyspeptic symptoms and abdominal pain pain in abdomen overof 20 days’ duration. On physical examination, the abdomen was found to be soft with diffuse tenderness, especially in the right hypochondrium.

Explanations

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