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胃腸病学のアドバンス校正サンプル
原発性副甲状腺機能亢進症（PHPT）による高カルシウム血症により誘発された急性膵炎は極めてまれな病態であり、その有病率は1.5％～7％と推定されている。インドで行われた過去の研究では、PHPTの発生率は6.8％から12％であると報告されている。しかし、PHPT患者および結果として生じる高カルシウム血症の患者は、一般集団の10～20倍の頻度で膵炎を経験する。一般に、低カルシウム血症は急性膵炎の発作時に起こると考えられている。したがって、高カルシウム血症はPHPTの強力な予測因子である。このような理由により、膵炎に伴う血清カルシウム値の上昇は、副甲状腺機能亢進症または悪性腫瘍を疑うよう医師に注意を促す。急性膵炎の代謝的原因には、副甲状腺機能亢進症併存の有無にかかわらず、糖尿病性ケトアシドーシス、高トリグリセリド血症、および高カルシウム血症などがあげられる。膵炎の最も一般的な病因は胆石症とアルコール依存症である。血清カルシウム値の異常は、一般的な病因ではないため、急性膵炎の初回発作と診断されたすべての患者において日常的に測定されるわけではない。一部の患者では、PHPTと診断される前に、2回以上の膵炎発作を起こす患者もいる。本稿では、重度の上腹部痛、嘔吐、3日間の発熱歴で消化器内科を受診した30歳女性の症例を報告する。患者には2か月前にも同様の症状があり、市民病院に入院し、急性膵炎と診断された。その後、保存的に管理され、7日後に退院した。患者には飲酒や高脂血症の既往はなかったが、1年半前に胆石症で胆嚢摘出術を受けた既往があった。適切な評価の後で、患者は胆嚢摘出術後の急性膵炎と診断され、保存的に管理された。その後5か月以内に20日以上の消化不良症状と腹痛が出現し、患者は再入院した。身体診断時に、腹部は軟らかく、放散性圧痛をともなっており、特に右季肋部に顕著であった。
Acute pancreatitis induced by hypecalcemia due to primary hyperparathyroidism (PHPT) is a very rare condition, and its prevalence is estimated to be between 1.5% and 7%. Studies from India report an incidence between 6.8% and 12%. However, in patients with PHPT and resulting hypercalcemia, pancreatitis occurs 10 to 20 times more often than in the general population. Normally, hypocalcemia is expected during an attack of acute pancreatitis and hypercalcemia is a strong clue for suspecting PHPT. Hence, elevated serum calcium associated with pancreatitis should alert the physician to either hyperparathyroidism or malignancy. The metabolic causes of acute pancreatitis include diabetic ketoacidosis, hypertriglyceridemia, and hypercalcemia with or without hyperparathyroidism. Gallstones and alcoholism are the commonest etiological agents of pancreatitis. Serum calcium is not routinely measured in all patients diagnosed with the first attack of acute pancreatitis as it is not the common cause. Some patients suffer from 2 or more attack of pancreatitis before the diagnosis of PHPT. We describe a 30-year-old female patient who presented to a gastroenterology unit with severe upper abdominal pain, vomiting, and fever of 3 days’ duration. She had a similar episode of symptoms 2 months previously, for which she was admitted to a civil hospital, where she was diagnosed as case of acute pancreatitis and was managed conservatively and discharged after 7 days. No additional risk factors causing acute pancreatitis such as alcohol consumption, hyperlipidemia, and gallstones were present. She had a history of cholecystectomy 1.5 years earlier for stone. After proper evaluation, a diagnosis of post-cholecystectomy acute pancreatitis was made, and the patient was managed conservatively. Within the next 5 months, she was again admitted with dyspeptic symptoms and pain in abdomen of 20 days’ duration. On examination, the abdomen was soft with diffuse tenderness, especially in the right hypochondrium.
Acute1 pancreatitis induced by hypecalcemiahypercalcemia due to primary hyperparathyroidism (PHPT) is a very rare condition, with the , and its prevalence is estimated to be between estimated to be between 1.5% and and 7%. 2 Previous Sstudies conductedfrom in3 India report an the incidence of PHPT 4 between to be between 6.8% and 12%. However, in patients with PHPT and resulting datetime=emia, experience pancreatitis occurs 5 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 is expected generally occurs during an attack of acute pancreatitis; thus,6 and hypercalcemia is a strong clue predictor for suspecting PHPT. Hence, findings of elevated serum calcium levels associated with pancreatitis should alert the physician to either be indicative of hyperparathyroidism or malignancy. The metabolic causes of acute pancreatitis include diabetic ketoacidosis, hypertriglyceridemia, and hypercalcemia with or without hyperparathyroidism. 7 The most common etiologies of pancreatitis are gGallstones and alcoholism. are the commonest etiological agents of pancreatitis. 8 Serum calcium level is not 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 attacks9 of pancreatitis before the being diagnosed withdiagnosis of PHPT. Here Wwe describe the case of a 30-year-old female patient who presented to a 胃腸病学 unit with severe upper abdominal pain, vomiting, and a 3-day history of fever of 3 days duration10 . She had experienced a similar episode ofsimilar symptoms 11 2 months previously, for which she was admitted to a civil hospital and diagnosed , where she was diagnosed as with case of acute pancreatitis. There, she was and was managed conservatively and discharged after 7 days. She had noNo additional risk factors causing acute pancreatitis such ashistory of alcohol consumption, or hyperlipidemia, and gallstones were present.; however, Sshe had a history of undergone cholecystectomy 1.5 years datetime=or gallstones. After proper evaluation, a she was diagnosed with diagnosis of post-cholecystectomy acute pancreatitis was made, a and the patient was managed conservatively. However, she was readmitted Wwithin the next 5 months, she was again admitted with after experiencing dyspeptic symptoms and abdominal pain pain in abdomen overof 20 days duration. On physical examination, the abdomen was found to be 12 soft with diffuse tenderness, especially particularly in the right hypochondrium.
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- This sentence was restructured to eliminate redundancy and wordiness. The article and preposition usage was rectified for better accuracy
- The preposition “from” indicates the origin of something. Whereas, this refers to the studies that were conducted in India. Therefore, the word choice and preposition were rectified here.
- The reference was unclear here. Although the facts were stated in the previous sentence, the edit here introduces more clarity that the “incidence of PHPT” is being referred to.
- The term “occur” is colloquial and does not align with the academic tone. Therefore, the edit here has been made to improve the word choice and retain the clients intent.
- 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 understand why hypercalcemia is a strong predictor for PHPT.
- The text has been re-arranged so that the reasons why elevated serum calcium levels can indicate the presence of hyperparathyroidism or malignancy can be more clearly understood.
- From the technical perspective, the use of the term “etiological agent” is incorrect here. “Agent” would refer to the material that would cause it, whereas here the disease conditions are being referred. Therefore, “agent” is an incorrect word choice.
- Ensuring accurate singular or plural form usage is essential for grammatical accuracy. Here, as more than one attack is being referred to, the plural form (attacks) is used.
- The phrase “3 days duration” is awkward and not a wide usage in academic writing. Therefore, this has been phrased for better readability.
- Removing redundancy aids in better readability and comprehension. Here, “a similar episode of symptoms” has been revised to “similar symptoms” to present the same idea in a more concise manner.
- The modifier phrase “found to be” adds meaning and enhances the readability of the sentence.
Acute pancreatitis induced by hypercalcemia due to primary hyperparathyroidism (PHPT) is very rare, with the prevalence estimated to be between 1.5% and 7%. Previous studies conducted in India report the incidence of PHPT to be between 6.8% and 12%. However, patients with PHPT and resulting hypercalcemia experience pancreatitis 10–20-fold more often than the general population. The metabolic causes of acute pancreatitis include diabetic ketoacidosis, hypertriglyceridemia, and hypercalcemia with or without hyperparathyroidism. Hypocalcemia generally occurs during an attack of acute pancreatitis; thus, hypercalcemia is a strong predictor for PHPT. Hence, findings of elevated serum calcium levels associated with pancreatitis should be indicative of hyperparathyroidism or malignancy. The most common etiologies of pancreatitis are gallstones and alcoholism. Serum calcium level is not routinely measured in all patients diagnosed with a first attack of acute pancreatitis as it is not a common etiology. Some patients suffer from two or more attacks of pancreatitis before being diagnosed with PHPT. Here we describe the case of a 30-year-old female who presented to a gastroenterology unit with severe upper abdominal pain, vomiting, and a 3-day history of fever. She had experienced similar symptoms 2 months previously, for which she was admitted to a hospital and diagnosed with acute pancreatitis. There, she was managed conservatively and discharged after 7 days. She had no history of alcohol consumption or hyperlipidemia; however, she had undergone cholecystectomy 1.5 years earlier for gallstones. After proper evaluation, she was diagnosed with post-cholecystectomy acute pancreatitis and was managed conservatively. However, she was readmitted within the next 5 months after experiencing dyspeptic symptoms and abdominal pain over 20 days. On physical examination, the abdomen was found to be soft with diffuse tenderness, particularly in the right hypochondrium.
