Acute pancreatitis induced by hypecalcemiahypercalcemia due to primary
hyperparathyroidism (PHPT) is a very rare condition, with the , and its prevalence isestimated to be between estimated to be between 1.5% and and 7%. Previous Sstudies
conductedfrom in India report an the incidence of PHPT between to be between 6.8% and12%. However, in patients with PHPT and resulting hypercalcemia, experience pancreatitis
occurs 10 to –20-fold times more often often thanthan in the general population. The
metabolic causes of acute pancreatitis include diabetic ketoacidosis, hypertriglyceridemia,
and hypercalcemia with or without hyperparathyroidism. Normally, hHypocalcemia isexpected generally occurs during an attack of acute pancreatitis; thus, and hypercalcemia is astrong clue predictor for suspecting PHPT. Hence, findings of elevated serum calcium levels
associated with pancreatitis should alert the physician to either be indicative ofComment [A1]: Terms such as thus, therefore,
furthermore, and however are used as transition
words to help in a better flow of ideas. Here, thus
helps connect the two sentences and helps a reader
understand that the former sentence helps understandwhy hypercalcemia is a strong predictor for PHPT.

hyperparathyroidism or malignancy. The metabolic causes of acute pancreatitis include
diabetic ketoacidosis, hypertriglyceridemia, and hypercalcemia with or without
hyperparathyroidism. The most common etiologies of pancreatitis are gGallstones andalcoholism. are the commonest etiological agents of pancreatitis. Serum calcium level is not

Comment [A2]: The text has been re-arranged sothat the reasons why elevated serum calcium levels
can indicate the presence of hyperparathyroidism ormalignancy can be more clearly understood.

routinely measured in all patients diagnosed with the a first attack of acute pancreatitis as it is
not the a common causeetiology. Some patients suffer from 2two or more attack attacks ofpancreatitis before the being diagnosed withdiagnosis of PHPT. Here Wwe describe the caseComment [A3]: Ensuring accurate singular orplural form usage is essential for grammaticalaccuracy. Here, as more than one attack is beingreferred to, the plural form (attacks) is used.

of a 30-year-old female patient who presented to a gastroenterology unit with severe upper
abdominal pain, vomiting, and a 3-day history of fever of 3 days’ duration. She had
experienced a similar episode ofsimilar symptoms 2 months previously, for which she wasadmitted to a civil hospital and diagnosed , where she was diagnosed as with case of acutepancreatitis. There, she was and was managed conservatively and discharged after 7 days.
She had noNo additional risk factors causing acute pancreatitis such ashistory of alcoholAll material in this document is the intellectual property of Crimson Interactive Pvt. Ltd. The use of informationand content in this document in whole or in part is forbidden unless express permission has been given inwriting by Crimson Interactive Pvt. Ltd.

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Comment [A4]: Removing redundancy aids inbetter readability and comprehension. Here, “asimilar episode of symptoms” has been revised to“similar symptoms” to present the same idea in amore concise manner.

consumption, or hyperlipidemia, and gallstones were present.; however, Sshe had a history ofundergone cholecystectomy 1.5 years earlier for gallstones. After proper evaluation, a she
was diagnosed with diagnosis of post-cholecystectomy acute pancreatitis was made, a and thepatient was managed conservatively. However, she was readmitted Wwithin the next 5months, she was again admitted with after experiencing dyspeptic symptoms and abdominal
pain pain in abdomen overof 20 days’ duration. On physical examination, the abdomen wasfound to be soft with diffuse tenderness, especially particularly in the right hypochondrium.

All material in this document is the intellectual property of Crimson Interactive Pvt. Ltd. The use of informationand content in this document in whole or in part is forbidden unless express permission has been given inwriting by Crimson Interactive Pvt. Ltd.

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