Hypercalcemia Causes More Severe Acute Pancreatitis: An International Multicenter Cohort Study.

Background

Hypercalcemia is a rare etiology of acute pancreatitis; only a few cases have been reported in the literature, and the severity of hypercalcemia-induced AP is unknown. We aimed to assess the occurrence and severity of hypercalcemia-induced AP and compare it with the clinical characteristics of AP caused by other etiological factors.

Methods

We collected data from patients from the Hungarian Acute Pancreatitis Registry who had AP, a serum calcium level above 2.6 mmol/L, and no other AP etiology. AP patients with etiologies other than hypercalcemia served as control.

Results

A total of 1.20% of our AP patients (16/1328) had a clear hypercalcemic etiology, 5.05% (67/1328) had a mixed etiology, and 1245 patients were in the control group. Severe AP, organ failure, and renal failure were significantly more common in patients with hypercalcemia-induced AP than in the control or the mixed etiology groups. Heart failure was significantly more frequent in the clear hypercalcemia-induced group than in patients with normal serum calcium AP. Respiratory failure was significantly more common in the clear hypercalcemia-induced AP group than in the mixed etiology-induced group. There was no significant difference in other analyzed parameters. The outcome of AP was not associated with the severity of hypercalcemia within the hypercalcemic group.

Conclusions

Compared with AP of different etiologies, hypercalcemia-induced AP is more likely to develop into severe AP and organ failure (heart and kidneys).