Primary hyperparathyroidism as a cause of calcific pancreatitis and diabetes mellitus in a young woman


DOI: https://dx.doi.org/10.18565/therapy.2021.6.128-135

Pogosyan K.A., Karonova Т.L., Yanevskaya L.G., Andreeva А.Т., Ryzhkova D.V., Belousova L.V., Tsoi U.A., Grineva E.N.

1) National Medical Research Centre named after V.A. Almazov of the Ministry of Healthcare of Russia, Saint Petersburg; 2) Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia
Abstract. Primary hyperparathyroidism (PHPT) is the third most common endocrine disorder. The manifest form still prevails in Russia; its classic clinical presentation involves bone, kidney, and gastrointestinal disturbance. Calcific pancreatitis associated with diabetes is a rare PHPT presentation. The case demonstrates the late diagnosis of PHPT, against the background of long-term unrecognized classic manifestations of PHPT, that included fibrocystic osteitis, as well as a nonclassical manifestation – calcific pancreatitis, that led to diabetes mellitus. Being undiagnosed and untreated for a long time, the disease developed severe complications both in a patient (fibrocystic osteitis, preterm labor, calcific pancreatitis, diabetes mellitus) and in a newborn (hypocalcemic seizures). After a parathyroidectomy was performed, the partial regression of bone changes was observed. Despite chronic calcific pancreatitis associated with diabetes being a rare manifestation of primary hyperparathyroidism, clinical symptoms of PHPT, and a history of chronic pancreatitis with repeated episodes of acute pancreatitis, should keep a high index of suspicion for hypercalcemia as a cause of pancreas damage.
Keywords: secondary diabetes, fibrocystic osteitis, pancreatitis, primary hyperparathyroidism
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About the Autors

Karina A. Pogosyan, resident of the Department of internal medicine, specialty «Endocrinology», National Medical Research Centre named after V.A. Almazov of the Ministry of Healthcare of Russia. Address: 194021, Saint Petersburg, 15 Parkhomenko Avenue. Tel.: +7 (921) 424-93-32. E-mail: karina.a.pogosyan@gmail.com. ORCID: 0000-0003-0628-0085. eLibrary SPIN: 3977-7644.
Tatiana L. Karonova, MD, chief researcher, head of the Research Laboratory of clinical endocrinology, professor of the Department of endocrinology, National Medical Research Centre named after V.A. Almazov of the Ministry of Healthcare of Russia, professor of the Department of faculty therapy with a course in endocrinology, cardiology and functional diagnostics named after G.F. Lang with the Clinic, Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia. Address: 194021, Saint Petersburg, 15 Parkhomenko Avenue. Tel.: +7 (921) 310-60-41. E-mail: karonova@mail.ru. ORCID: 0000-0002-1547-0123. eLibrary SPIN: 3337-4071
Lyubov G. Yanevskaya, junior researcher of the Research Laboratory of clinical endocrinology of the Institute of endocrinology, National Medical Research Centre named after V.A. Almazov of the Ministry of Healthcare of Russia. Address: 194021, Saint Petersburg, 15 Parkhomenko Avenue. E-mail: fosterthefire@yandex.ru. ORCID: 0000-0003-2271-8139. eLibrary SPIN: 1359-2238
Alena T. Andreeva, junior researcher of the Research Laboratory of clinical endocrinology of the Institute of endocrinology, National Medical Research Centre named after V.A. Almazov of the Ministry of Healthcare of Russia. Address: 194021, Saint Petersburg, 15 Parkhomenko Avenue. E-mail: arabicaa@gmail.com. ORCID: 0000-0002-4878-6909. eLibrary SPIN: 6051-7214
Daria V. Ryzhkova, MD, professor, chief researcher of the Research Department of nuclear medicine and theranostics of the Institute of oncology and hematology, head of the scientific and clinical association of nuclear medicine, head of the Department of nuclear medicine and radiation technologies of the Institute of medical education, National Medical Research Centre named after V.A. Almazov of the Ministry of Healthcare of Russia, radiologist of the highest category, professor of RAS. Address: 197341, Saint Petersburg, 2 Akkuratova Str. E-mail: d_ryjkova@mail.ru. ORCID: 0000-0002-7086-9153. eLibrary SPIN: 7567-6920
Lidia V. Belousova, endocrinologist of the highest category, head of the Department of endocrinology No. 2, National Medical Research Centre named after V.A. Almazov of the Ministry of Healthcare of Russia. Address: 194021, Saint Petersburg, 15 Parkhomenko Avenue.
Uljana A. Tsoi, PhD, head of the Research Laboratory of neuroendocrinology, leading researcher, associate professor of the Department of internal medicine of the Institute of medical education, National Medical Research Centre named after V.A. Almazov of the Ministry of Healthcare of Russia. Address: 194021, Saint Petersburg, 15 Parkhomenko Avenue. E-mail: utsoi@mail.ru. ORCID: 0000-0003-4013-4831. eLibrary SPIN: 3294-2857
Elena N. Grineva, MD, professor, Director of the Institute of endocrinology, chief researcher of the Research Laboratory of neuroendocrinology, National Medical Research Centre named after V.A. Almazov of the Ministry of Healthcare of Russia, chief freelance specialist endocrinologist for the Northwestern Federal District. Address: 194021, Saint Petersburg, 15 Parkhomenko Avenue. E-mail: grineva_e@mail.ru. ORCID: 0000-0003-0042-7680. eLibrary SPIN: 2703-0841


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