From the Guidelines

Hypercalcemia is not a common finding in pancreatitis, and in fact, hypocalcemia is more frequently observed.

There is no direct evidence in the provided study 1 that suggests a common cause of hypercalcemia in pancreatitis.
However, it is mentioned that free fatty acids (FFA) may lead to intravascular sequestration of calcium by creating FFA-albumin complexes, which would actually contribute to hypocalcemia, not hypercalcemia.
The study focuses more on the relationship between hypertriglyceridemia and pancreatitis, and how treatment of hypertriglyceridemia can improve outcomes in pancreatitis.
It is worth noting that hypocalcemia is a well-known negative prognostic factor in acute pancreatitis, with calcium levels below 2 mmol/l being a concern 1.
In the context of real-life clinical medicine, it is essential to prioritize the treatment of hypertriglyceridemia and monitor calcium levels closely to prevent complications, rather than focusing on hypercalcemia as a common cause in pancreatitis.

From the Research

The causes of hypercalcemia in pancreatitis can be attributed to several factors, including:

Hyperparathyroidism, which can lead to elevated serum calcium levels and increase the risk of acute pancreatitis 2, 3, 4, 5
Primary hyperparathyroidism, which is a rare cause of acute pancreatitis, accounting for less than 1% of cases 4
Hypercalcemia due to hyperparathyroidism, which can cause calcium deposits in the pancreatic ducts and activation of pancreatic enzymes, leading to acute pancreatitis 3
Elevated parathyroid hormone and high serum calcium levels, which can be responsible for the development of acute pancreatitis 3

The pathophysiology of hypercalcemia-induced pancreatitis is not fully understood, but it is thought that:

Elevated serum calcium levels can lead to premature protease activation and pancreatic enzyme activation, resulting in pancreatic damage 6
Hypercalcemia can cause an increase in calcium in the pancreatic parenchyma and ducts, leading to aggression of the pancreatic tissue and ducts 4
Pancreatic secretion in patients with hypercalcemia may be lower than normal, but enzyme activity remains normal, resulting in the formation of protein plugs in the pancreatic ducts and leading to their obstruction and self-digestion 4

The clinical presentation of hypercalcemia-induced pancreatitis can vary, but it is often characterized by:

Acute pancreatitis, which can be severe and recurrent 2, 3, 4, 5
Elevated serum calcium levels, which can be associated with primary hyperparathyroidism 2, 3, 4, 5
Pancreatic enzyme activation and premature protease activation, which can lead to pancreatic damage 6