Diabetes mellitus, chronic pancreatitis and primary hyperparathyroidism: is there a connection?
Abstract
Hyperparathyroidism is a relatively frequent condition characterized by hypersecretion of parathyroid hormone. There are several forms of primary hyperparathyroidism. Each form affects its target region. In the visceral form, nephrocalcinosis, nephrolithiasis and peptic and duodenal ulcers are common. The pancreas is also a target organ. This article describes a clinical case of a patient with diabetes mellitus and previously treated primary hyperparathyroidism. The patient was admitted to the hospital due to poor glycaemic control. During the hospitalization, diabetes mellitus developed as a consequence of frequent relapses of chronic pancreatitis (outcome of the visceral form of primary hyperparathyroidism and severe hypertriglyceridemia). Glycaemic control was achieved after treatment of acute pancreatitis and insulin administration. This clinical case is an example of the impact of previous primary hyperparathyroidism (even after radical treatment and remission) on the development of a multi-faceted comorbidity.
Supporting agencies: The patient was hospitalized at the Federal State Budgetary Institution Scientific Research Center for Endocrinology of the Ministry of Health of the Russian Federation and was examined at the expense of the compulsory medical insurance fund.
About the Authors
Anna M. Gorbacheva
Endocrinology research centre
Russian Federation
Russian Federation
resident
Nataliya V. Zaytseva
Endocrinology research centre
Russian Federation
Russian Federation
MD, PhD, Diabetic nephropathy and haemodyalisys department
References
1. Bilezikian JP, Cusano NE, Khan AA, et al. Primary hyperparathyroidism. Nat Rev Dis Primers. 2016;2:16033. doi: https://doi.org/10.1038/nrdp.2016.33
2. Bilezikian JP, Bandeira L, Khan A, Cusano NE. Hyperparathyroidism. Lancet. 2018;391(10116):168-178. doi: https://doi.org/10.1016/s0140-6736(17)31430-7
3. Khan AA, Hanley DA, Rizzoli R, et al. Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus. Osteoporos Int. 2017;28(1):1-19. doi: https://doi.org/10.1007/s00198-016-3716-2
4. Дедов И.И., Рожинская Л.Я., Мокрышева Н.Г., и др. Этиология, патогенез, клиническая картина, диагностика и лечение первичного гиперпаратиреоза // Остеопороз и остеопатии. — 2010. — Т. 13. — №1. — С. 13-18. [Dedov II, Rozhinskaya LY, Mokrysheva NG, et al. Etiology, pathogenesis, clinical presentation, diagnosticsand treatment of the primary hyperparathyroidism. Osteoporosis and Bone Diseases. 2010;13(1):13-18. (In Russ.)] doi: https://doi.org/10.14341/osteo2010113-18
5. Bai HX, Giefer M, Patel M, et al. The association of primary hyperparathyroidism with pancreatitis. J Clin Gastroenterol. 2012;46(8):656-661. doi: https://doi.org/10.1097/MCG.0b013e31825c446c
6. Racz GZ, Kittel A, Riccardi D, et al. Extracellular calcium sensing receptor in human pancreatic cells. Gut. 2002;51(5):705-711. doi: https://doi.org/10.1136/gut.51.5.705
7. Hart PA, Bellin MD, Andersen DK, et al. Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer. Lancet Gastroenterol Hepatol. 2016;1(3):226-237. doi: https://doi.org/10.1016/s2468-1253(16)30106-6
8. Serrano J, Andersen DK, Forsmark CE, et al. Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer: From Concept to Reality. Pancreas. 2018;47(10):1208-1212. doi: https://doi.org/10.1097/MPA.0000000000001167
9. Ewald N, Kaufmann C, Raspe A, et al. Prevalence of diabetes mellitus secondary to pancreatic diseases (type 3c). Diabetes Metab Res Rev. 2012;28(4):338-342. doi: https://doi.org/10.1002/dmrr.2260
10. Yadav D, Park WG, Fogel EL, et al. PROspective Evaluation of Chronic Pancreatitis for EpidEmiologic and Translational StuDies: Rationale and Study Design for PROCEED From the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer. Pancreas. 2018;47(10):1229-1238. doi: https://doi.org/10.1097/MPA.0000000000001170
11. Руяткина Л.А., Руяткин Д.С. Панкреатогенный сахарный диабет/сахарный диабет типа 3с: современное состояние проблемы // Медицинский Совет. — 2018. — №4. — С. 28-35. [Ruiatkina LA, Ruiatkin DS. Pancreatogenic diabetes / type 3c diabetes: status update on the problem. Medical Council. 2018;(4):28-35. (In Russ.)] doi: https://doi.org/10.21518/2079-701X-2018-4-28-35
12. Tirkes T, Shah ZK, Takahashi N, et al. Reporting Standards for Chronic Pancreatitis by Using CT, MRI, and MR Cholangiopancreatography: The Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer. Radiology. 2019;290(1):207-215. doi: https://doi.org/10.1148/radiol.2018181353
13. Zhang W, Doherty M, Pascual E, et al. EULAR evidence based recommendations for gout. Part I: Diagnosis. Report of a task force of the Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2006;65(10):1301-1311. doi: https://doi.org/10.1136/ard.2006.055251
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1. Fig. 1. Schematic representation of the patient’s history: GFR — glomerular filtration rate; CKD - chronic kidney disease; hr - chronic; PTH - parathyroid hormone; pr. lower PSG - the right lower parathyroid gland; Vit. - vitamin; HELL - blood pressure. | |
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Gorbacheva A.M., Zaytseva N.V. Diabetes mellitus, chronic pancreatitis and primary hyperparathyroidism: is there a connection? Diabetes mellitus. 2019;22(4):392-398. (In Russ.)
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