ACUTE-PANCREATITIS INDUCED BY HYPERCALCEMIA ASSOCIATED WITH ADULT T-CELL LEUKEMIA - A CASE-REPORT

A 44 year old Japanese woman with adult T-cell leukaemia (ATL) was adm itted to Kyushu University hospital to receive a course of alpha-inter feron treatment. She experienced a sudden onset of hypercalcaemia and epigastric pain associated with an increase in the level of pancreatic enzymes. Her serum parathyroid hormone related protein level was abov e normal although her high sensitive PTH level was within the normal r ange. Ultrasonography and computed tomography (CT) of the abdomen show ed enlargement of the pancreas with indistinct margins and massive acc umulation of extrapancreatic fluid. Cullen's sign was observed. A few days after the onset of acute pancreatitis, the serum amylase level in creased to 3400 IU/L, and the serum calcium level fell to 4.2 mg/dL fr om 13.3 mg/dL. Her fasting blood glucose level increased to 242 mg/dL. Although the first episode of pancreatitis appeared to respond to tre atment, she experienced a second episode of pancreatitis accompanied b y an elevation of the serum calcium level. These findings suggest that acute pancreatitis was caused by hypercalcaemia associated with ATL.