{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T11:00:43Z","timestamp":1784718043505,"version":"3.55.0"},"reference-count":20,"publisher":"The Endocrine Society","issue":"8","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Primary hyperparathyroidism is an endocrine disorder with diverse clinical and biochemical manifestations. Albright classically described the condition as a disease of \u201cstones, bones, groans, and moans.\u201d Its clinical spectrum may include recurrent acute pancreatitis secondary to hypercalcemia. Although biochemically the disorder typically presents with elevated serum calcium, reduced serum phosphate, and increased parathyroid hormone (PTH) levels, atypical manifestations are possible. We report the case of a 41-year-old man who presented with recurrent episodes of acute pancreatitis and on evaluation was found to have persistently elevated serum calcium and low serum phosphorus levels with intact PTH (iPTH) concentrations within the laboratory reference range. In the context of hypercalcemia, a normal PTH level was considered inappropriately normal because physiologic feedback would typically suppress PTH secretion. Consequently, normo-hormonal primary hyperparathyroidism (NHpHPT) was suspected, and localization workup undertaken. Dual-phase technetium 99mTc Sestamibi scintigraphy demonstrated a right inferior parathyroid adenoma, subsequently confirmed by four-dimensional computed tomography (4D-CT). The patient had bilateral renal calculi. Focused right inferior parathyroidectomy resulted in biochemical normalization and marked clinical improvement. This case highlights the heterogeneous manifestations of primary hyperparathyroidism and emphasizes that a normal PTH level in the context of hypercalcemia does not exclude the diagnosis of hyperparathyroidism.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag196","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T10:01:01Z","timestamp":1784714461000},"source":"Crossref","is-referenced-by-count":0,"title":["Normo-hormonal primary hyperparathyroidism presenting with recurrent acute pancreatitis"],"prefix":"10.1210","volume":"4","author":[{"given":"Bodhisattwa","family":"Mishra","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, AII India Institute of Medical Sciences (AIIMS) , Bhubaneswar 751019 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonalika","family":"Sahoo","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, AII India Institute of Medical Sciences (AIIMS) , Bhubaneswar 751019 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6274-465X","authenticated-orcid":false,"given":"Sayantan","family":"Ray","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, AII India Institute of Medical Sciences (AIIMS) , Bhubaneswar 751019 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kishore Kumar","family":"Behera","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, AII India Institute of Medical Sciences (AIIMS) , Bhubaneswar 751019 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakash Kumar","family":"Sasmal","sequence":"additional","affiliation":[{"name":"Department of General Surgery, AII India Institute of Medical Sciences (AIIMS) , Bhubaneswar 751019 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"issue":"8","key":"2026072206005609300_luag196-B1","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1210\/jcem-8-8-637","article-title":"A page out of the history of hyperparathyroidism","volume":"8","author":"Albright","year":"1948","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2026072206005609300_luag196-B2","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1007\/BF01655425","article-title":"Psychiatric morbidity in primary hyperparathyroidism","volume":"12","author":"Joborn","year":"1988","journal-title":"World J Surg"},{"issue":"9","key":"2026072206005609300_luag196-B3","doi-asserted-by":"crossref","first-page":"3015","DOI":"10.1210\/clinem\/dgaa419","article-title":"Reduced calcium sensing receptor (CaSR) expression is epigenetically deregulated in parathyroid adenomas","volume":"105","author":"Singh","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2026072206005609300_luag196-B4","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1046\/j.1365-2265.2000.00933.x","article-title":"Calcium-sensing receptor expression and signalling in human parathyroid adenomas and primary hyperplasia","volume":"52","author":"Corbetta","year":"2000","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"8","key":"2026072206005609300_luag196-B5","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1111\/j.1445-2197.2006.03845.x","article-title":"Does hyperparathyroidism cause pancreatitis? 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