Acute Pancreatitis Secondary to Hypercalcemia of Multiple Myeloma

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Abstract
Pancreatitis complicating hyperpara-thyroidism has been amply confirmed; with more than 60 cases in which these two states coexisted have been reported. A patient with multiple myeloma and marked hypercalcemia was found to have acute necrotizing pancreatitis at autopsy. The parathyroid glands were normal, thus eliminating hyperparathyroidism as an etiologic possibility. An interesting aspect of this case is that the pancreatitis did not develop at the time of the hypercalcemic crisis. It would appear, therefore, that certain circumstances exist for pancreatitis to develop in the presence of an elevated serum calcium level and that hypercalcemia alone is not wholly responsible. These situations include dehydration, debility and hypoproteinemia. It is suggested that patients with pancreatitis should be studied not only for hyperparathyroidism but for other causes of hypercalcemia as well, and that the basic mechanism for pancreatitis is hypercalcemia and not hyperparathyroidism.

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