November 28, 1980

Hyperparathyroidism and Pancreatitis

Author Affiliations

Veterans Administration Medical Center San Francisco

JAMA. 1980;244(21):2413. doi:10.1001/jama.1980.03310210015006

To the Editor.—  I read the article by Bess et al (243:246, 1980) in which the authors stated "A review of the available data, including experimental evidence, does not support a cause-and-effect relationship between primary hyperparathyroidism or hypercalcemia and pancreatitis." Although their results in 1,153 patients with surgically confirmed primary hyperparathyroidism support this statement, other studies would suggest that there is a causal relationship between severe hyperparathyroidism and acute pancreatitis. Thus, acute pancreatitis has been reported to occur in about 16% of patients with parathyroid cancers and profound hypercalcemia, and about 25% of patients with a serum calcium level greater than 17 mL/dL have pancreatitis (192:916, 1965).1 Pancreatitis is also frequently found in patients dying of hypercalcemic crises secondary to hyperparathyroidism.1,2Although this information does not prove that there is a causal relationship between pancreatitis and hyperparathyroidism, it appears that this relationship does exist.