Hypercalcemic pancreatitis a rare presentation of sarcoidosis: A case report

Medicine
Agazi GebreselassieAngesom Kibreab

Abstract

The usual presentation of sarcoidosis is hilar adenopathy, pulmonary reticular opacities, skin, joint, or eye lesions. Pancreatic involvement is unusual and hypercalcemic pancreatitis as initial manifestation is very rare. We present a case that presented with 1-day history of vomiting, diffuse abdominal pain, and altered mental status. Initial investigations showed highly elevated calcium levels, acute pancreatitis, and kidney failure. Possible causes entertained were malignancy, hyperparathyroidism, hypervitaminosis D, and granulomatous diseases. Full work-up including a hilar lymph node biopsy revealed noncaseating granuloma. After excluding other diseases capable of producing a similar picture, a diagnosis of sarcoidosis was made. The patient was started on aggressive intravenous fluid hydration and intravenous calcitonin, after which her altered mental status resolved and both kidney function and hypercalcemia improved. The patient was discharged on oral prednisone and serum calcium level normalized with progressive improvement of kidney function at follow-up. The current case highlights the need for a high index of suspicion for this condition in patients who present with acute pancreatitis, as steroids are the treatment ...Continue Reading

References

Mar 16, 2000·Clinical Endocrinology·S T HadenG El-Hajj Fuleihan
Dec 6, 2001·American Journal of Respiratory and Critical Care Medicine·R P BaughmanUNKNOWN Case Control Etiologic Study of Sarcoidosis (ACCESS) research group
Feb 3, 2006·The European Respiratory Journal·D GuptaK Joshi

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Methods Mentioned

BETA
electrophoresis
biopsy

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