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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

States of hypersecretion of PTH may occur primarily, or in response to other physiologic abnormalities. Primary hyperparathyroidism must be considered in the differential diagnosis of hypercalcemia, nephrolithiasis, metabolic bone disease, and pancreatitis and peptic-ulcer disease. The clinical manifestations of this disease have become more subtle with improved detection. The serum calcium level is almost always elevated, and when it it accompanied by relatively high serum PTH levels or increased urinary cAMP excretion, the diagnosis is usually secure. Findings of hypophosphatemia, decreased renal tubular reabsorption of phosphorus, hypercalciuria, and characteristic roentgenographic changes support the diagnosis of hyperparathyroidism, but are not prerequisites for that diagnosis. Most cases will come to operation, and experienced intraoperative assessment is necessary for the correct distinction between multiglandular disease and that involving only a single gland. We expect that a clearer understanding of the histopathologic features of these diseases, and improvement in the methods for measurement of PTH will be the main areas of advancement in the diagnosis of hyperparathyroidism in the next few years.
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PMID:Diagnosis of hyperparathyroidism. 19 30

Definite inherited defect in hereditary pancreatitis (HP) is not known. A new kindred with 3 definite and 6 suspected cases of HP was investigated for possible inherited abnormalities. No aminoaciduria (except for a slight rise in urinary histidine in one patient) and no hyperparathyroidism, hyperlipidemia, or chromosomal abnormality was present. An increase in serum IgM level of a polyclonal type was noted in 3 definitely affected sisters and also in 2 nonaffected members. Serum alpha-1-antitrypsin and serum trypsin inhibition were normal. However, very marked dilatation and ectasia of the pancreatic duct were found in the propositus. Reviewing the data from this family and previously described kindreds, it is postulated that the genetic abnormality in HP encompasses a wide variety of structural and anatomical defects in the sphincter of Oddi or the pancreatic ductal system. These predispose to intermittent obstruction of the duct with concomitant activation of enzymes and ductal metaplasia. In suspected cases an early effort should be made to outline the pancreatic duct as the defect may be amenable to surgery.
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PMID:Inherited defect in hereditary pancreatitis. 30 62

Pancreatitis has been described previously following renal transplantation, but not in association with chronic renal failure. Analysis of 168 patients with renal transplants revealed five who developed pancreatitis, three of whom died. All five were on treatment with prednisone and azathioprine. Four patients were seen with definite attacks of pancreatitis and chronic, stable renal failure from a variety of causes. None had received immunosuppressive agents, prednisone nor thiazide diuretics, but two were on regular frusemide. One patient was on maintenance dialysis, which could not be related directly to the pancreatitis. In either group alcohol ingestion, cholethiathiasis, or hypercalcaemia was not a factor. This diagnosis of pancreatitis was established on clinical grounds and serum amylast levels of greater than 900 iu/1. Similar serum amylast elevation was not found ina random group of patients with chronic renal failure. Hyperlipidaemia was not present in any patient with pancreatitis. Although hypercalcaemia and primary hyperparathyroidism was not found in the transplant and non-transplant subjects, elevated serum parathormone levels have been described in uraemic patients with normocalcaemia. Hyperparathyroidism may be a factor in the development of pancreatitis in reanl failure. Pancreatitis carries a significant mortality risk in renal transplantation. The four non-transplanted patients have survived, despite recurrent attacks of pancreatitis.
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PMID:Pancreatitis and renal disease. 31 21

A case of acute pancreatitis associated with hyperparathyroidism in the third trimester of pregnancy is summarized, and the clinical findings are discussed. Emphasis is placed on recognition of pancreatitis and its etiology in the third trimester of pregnancy. The surgical approach to the parathyroid pathology is analyzed and its advantages espoused.
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PMID:Acute pancreatitis and hyperparathyroidism in pregnancy. 46 Jul 63

Post-transplantation pancreatitis occurs with a frequency of about 3 per cent and carries a mortality of 70 per cent. An average of 216 days following transplantation elapses before the onset of pancreatitis and tends to occur most frequently in men in the fourth decade of life. A multiplicity of factors which predispose to pancreatitis are present in the post-transplant period and may be responsible for the frequency and lethality of post-transplant pancreatitis. Among these factors are immunosuppressive therapy, consisting of azathioprine and steroids, secondary hyperparathyroidism and increased susceptibility to infection.
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PMID:Post-transplantation pancreatitis. 79 Jun 14

The value of conservative treatment in a case of chronic advanced renal failure was investigated in a 5-year-old girl with congenital hypoplastic kidneys. Before treatment the patient was severely anorexic and her plasma urea nitrogen was 180 mg/100 ml. Protein restriction alone was fruitless. After a transitional period on total parenteral therapy the patient was put on a maintenance oral diet, where an energy-rich diet was supplemented with essential amino acids including histidine. Plasma urea nitrogen dropped and stayed at about 50 mg/100 ml during the whole treatment in spite of a rising plasma creatinine from 10 to 24 mg/100 ml. The general condition of the patient normalized as she went into an anabolic state with weight gain and growth in height. The nitrogen balance studied in two different periods was positive. An acute attack of pancreatitis, secondary to hyperparathyroidism, ended the patient's life after 22 months of treatment.
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PMID:Essential amino acids in the treatment of advanced uremia: twenty-two months' experience in a 5-year-old girl. 81 Jul 64

Serum calcitonin (Ct) levels, serum calcium, and urine amylast were analyzed in 29 patients with an acute pancreatitis collected at random. In two of the patients the acute pancreatitis complicated a primary hyperparathyroidism. It was found that the calcitonin levels in serum were usually elevated during the acute phase of the pancreatitis. During this phase of the disease 22 of 27 examined patients had Ct-values above the upper normal limit of 1 mug/ml. The patients with normal Ct-values also had moderately elevated amylast values and a less pronounced pancreatitis. Normal Ct-values were usually found in patients more than 10 days after the onset of symptoms. Serum calcium was mostly within normal limits. However, a slight fall in serum calcium or low values was recorded in six patients with a pronounced disese. One patient with hyperparathyroidism normalized a previously elevated serum calcium during the calcitonin release.
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PMID:Serum calcitonin in acute pancreatitis in man. 83 66

A female with premary hyperparathyroidism and secondary renal lesions, as well as lesions of the stomach and pancreas is described. The initial illness was manifested by repeated renal crises. Later, gastroenterological complaints appeared--epigastralgia, vomiting, frequent hematemesis with melena. That was the cause for a gastric resection, diffuse erosive gastritis being found. After the operation, the pains and the vomiting of hematin matter repeatedly recidivated. Clinically and at the laboratory, data were formed for a chronic recidivating pancreatitis with the presence of primary hyperparathyroidism. The postoperative treatment of the parathyroid adenoma led to an improvement of the gastroenterological complaints.
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PMID:[Chronic recurrent pancreatitis with erosive gastritis in a patient with primary hyperparathyroidism]. 101 31

The major symptoms presented by the elderly patient with primary hyperparathyroidism (HPT) were studied in 30 patients, all of whom were over 70 years of age (70-89). Neuromuscular symptoms, fatigue or mental symptoms were the main complaint in 14 patients. Nephrolithiasis, pancreatitis, skeletal changes or thyroid diseases were associated with HPT in 13 patients. Three patients were considered to be asymptomatic. Seven out of the eight patients with neuromuscular symptoms, and two of the three patients with extreme fatigue as the dominant symptom, improved postoperatively. This study indicates that for elderly patients with HPT especially when associated with neuromuscular symptoms or fatigue, surgical therapy is the treatment of choice.
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PMID:Indications for surgery in the elderly patient with primary hyperparathyroidism. 102 May 88

Although carcinoid tumors in association with multiple endocrine neoplasia syndrome (MEN) has been well described, thymic carcinoid in association with MEN is extremely rare (only 23 cases in the world literature). A patient with thymic carcinoid and MEN-I was treated with surgical resection and postoperative radiation therapy, which was later followed by subtotal parathyroidectomy for hyperparathyroidism. Four years later, a symptomatic recurrence of his thymic carcinoid was resected from below his right clavicle. Six years after his original operation, the patient came to the hospital with pancreatitis, and a 5 cm, distal, pancreatic metastasis was resected. He now has symptomatic paraspinal and pleural metastases and is receiving somatostatin. Review of the world's literature shows that the majority of patients with thymic carcinoid and MEN-I are men with an average age of 37 years. Their clinical course is indolent, and surgery represents the only means of cure. Adjuvant chemotherapy and radiation therapy confer no survival advantage. The surgical decision making involved in treating a patient with thymic carcinoid and hyperparathyroidism associated with MEN is also discussed.
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PMID:Thymic carcinoid in association with MEN syndromes. 135 92


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