Gastroenterology report · 2026
Primary hyperparathyroidism-associated pancreatitis: poor prognosis, distinct serum calcium trajectories, and proactive therapeutic implications.
СтатьяНазвание и аннотация: Перевод в очереди
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Chen Yonghao, Fan Zhengyang, Li Jianing, Wang Yabing, Lyu Chengzhen, Yang Zihan, Jiang Qingwei, Wu Dong
Аннотация
BACKGROUND: Primary hyperparathyroidism (PHPT) is an uncommon but clinically significant cause of acute pancreatitis (AP). Its clinical course and prognosis remain inadequately characterized compared to common AP etiologies.
METHODS: A bibliometric analysis was performed to evaluate global research trends on PHPT-associated acute pancreatitis (PHPT-AP). We conducted a retrospective cohort study at Peking Union Medical College Hospital between 2000-2025. Clinical data were compared with patients with biliary and hypertriglyceridemia-induced AP. Subgroup analyses evaluated differences between PHPT with mild/moderately severe AP and severe AP (SAP), and between AP and chronic pancreatitis (CP). Statistical analyses included logistic regression and Mann-Whitney U tests.
RESULTS: The bibliometric results revealed limited literatures but increasing attention to PHPT-pancreatitis. Our cohort showed PHPT-AP patients exhibited worse outcomes compared to non-PHPT-AP, with higher risks of SAP (OR 3.73, 95% CI 1.28-10.86, P = 0.016), intensive care unit admission (OR 3.79, 95% CI 1.17-12.32, P = 0.027), and in-hospital mortality (OR 12.76, 95% CI 1.52-107.3, P = 0.019). Serum calcium (median 4.2 mmol/L vs. 3.5 mmol/L, P = 0.015) and parathyroid hormone (median 1514.0 pg/mL vs. 312.0 pg/mL, P = 0.007) were significantly higher in PHPT-SAP. A three-phase calcium trajectory was observed in SAP: an initial hypercalcemic phase, a plateau under therapy, and eventual normalization after surgical or extracorporeal interventions. PHPT-CP was associated with longer PHPT duration, recurrent AP, and higher diabetes prevalence.
CONCLUSION: PHPT-AP is associated with a worse prognosis and requires proactive management. Serum calcium correlates with severity and should be monitored dynamically. Early surgery or continuous veno-venous hemofiltration may be warranted in severe cases. Prolonged PHPT with recurrent AP and lifestyle risk factors may contribute to CP.
METHODS: A bibliometric analysis was performed to evaluate global research trends on PHPT-associated acute pancreatitis (PHPT-AP). We conducted a retrospective cohort study at Peking Union Medical College Hospital between 2000-2025. Clinical data were compared with patients with biliary and hypertriglyceridemia-induced AP. Subgroup analyses evaluated differences between PHPT with mild/moderately severe AP and severe AP (SAP), and between AP and chronic pancreatitis (CP). Statistical analyses included logistic regression and Mann-Whitney U tests.
RESULTS: The bibliometric results revealed limited literatures but increasing attention to PHPT-pancreatitis. Our cohort showed PHPT-AP patients exhibited worse outcomes compared to non-PHPT-AP, with higher risks of SAP (OR 3.73, 95% CI 1.28-10.86, P = 0.016), intensive care unit admission (OR 3.79, 95% CI 1.17-12.32, P = 0.027), and in-hospital mortality (OR 12.76, 95% CI 1.52-107.3, P = 0.019). Serum calcium (median 4.2 mmol/L vs. 3.5 mmol/L, P = 0.015) and parathyroid hormone (median 1514.0 pg/mL vs. 312.0 pg/mL, P = 0.007) were significantly higher in PHPT-SAP. A three-phase calcium trajectory was observed in SAP: an initial hypercalcemic phase, a plateau under therapy, and eventual normalization after surgical or extracorporeal interventions. PHPT-CP was associated with longer PHPT duration, recurrent AP, and higher diabetes prevalence.
CONCLUSION: PHPT-AP is associated with a worse prognosis and requires proactive management. Serum calcium correlates with severity and should be monitored dynamically. Early surgery or continuous veno-venous hemofiltration may be warranted in severe cases. Prolonged PHPT with recurrent AP and lifestyle risk factors may contribute to CP.