Primary hyperparathyroidism mimicking hyperemesis gravidarum.

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Internal Medicine

Background:

• Nausea and vomiting are common in pregnancy, often diagnosed as hyperemesis gravidarum.
• Hypercalcemia can present with similar gastrointestinal symptoms and poses maternal-fetal risks.
• Primary hyperparathyroidism is a rare cause of hypercalcemia during pregnancy.

Purpose of the Study:

• To highlight the diagnostic challenges of primary hyperparathyroidism presenting as hyperemesis gravidarum.
• To discuss the management and outcomes of hyperparathyroidism in pregnancy.

Main Methods:

• Case report of a 23-year-old pregnant woman with persistent nausea and vomiting.
• Diagnostic workup including biochemical tests to identify hypercalcemia.
• Treatment involved conservative management followed by surgical resection of a parathyroid adenoma.

Main Results:

• The patient's symptoms were initially misattributed to hyperemesis gravidarum.
• Hypercalcemia was discovered after multiple medical evaluations.
• Surgical removal of the parathyroid adenoma led to complete symptom resolution.

Conclusions:

• Primary hyperparathyroidism should be considered in pregnant patients with refractory nausea and vomiting.
• Multidisciplinary management is crucial for optimizing maternal-fetal outcomes.
• Surgical intervention can be safe and effective for managing primary hyperparathyroidism during pregnancy.