Calcium Elevation in Pancreatitis: Mechanisms and Implications

Mechanisms of Calcium Changes in Pancreatitis

In acute pancreatitis, circulating lipase and phospholipase released during pancreatic inflammation cleave triglycerides and raise serum free fatty acids (FFA), leading to hypocalcemia 2
These free fatty acids may lead to intravascular sequestration of calcium by creating FFA-albumin complexes, resulting in hypocalcemia 2
Hypocalcemia is frequently observed in patients with acute pancreatitis, with calcium levels below 2 mmol/L being a well-known negative prognostic factor 2
In pancreatitis, calcium levels are typically decreased rather than elevated due to free fatty acids binding to calcium and forming insoluble calcium soaps in areas of fat necrosis, leading to hypocalcemia, which is a frequent finding in acute pancreatitis and is considered a negative prognostic factor when levels fall below 2 mmol/L 1

In the absence of gallstones or significant history of alcohol use, serum calcium levels should be measured, as recommended by the World Journal of Emergency Surgery 3