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Hyperparathyroid crisis presenting with hyperemesis gravidarum
Banu Aktaş Yilmaz1, Mustafa Altay, Ceyla Konca Değertekin
1Department of Endocrinology and Metabolism, Gazi University School of Medicine, Ankara, Turkey, baktasyilmaz@yahoo.com.
Archives of Gynecology and Obstetrics
|July 17, 2014
Summary
Primary hyperparathyroidism in pregnancy can mimic hyperemesis gravidarum. Prompt diagnosis and parathyroidectomy are crucial for managing hypercalcemic crisis, preventing maternal and fetal complications.
Area of Science:
- Endocrinology
- Obstetrics & Gynecology
Background:
- Primary hyperparathyroidism is rare during pregnancy, often presenting with symptoms overlapping those of hyperemesis gravidarum.
- Accurate diagnosis is vital to prevent severe maternal and fetal complications.
Observation:
- A 22-year-old pregnant woman presented with hyperparathyroid crisis at 11 weeks' gestation, initially hospitalized for hyperemesis gravidarum.
- Severe hypercalcemia (17.59 mg/dL) was identified upon third admission, leading to a diagnosis of parathyroid crisis.
Findings:
- Urgent parathyroidectomy effectively resolved maternal hypercalcemia.
- The infant was delivered at 33 weeks' gestation without neonatal hypocalcemia or tetany.
Implications:
- Hyperemesis gravidarum can precipitate hypercalcemic crisis in undiagnosed primary hyperparathyroidism; serum calcium monitoring is recommended for deteriorating cases.
- While sharing some pathogenic links, primary hyperparathyroidism is not definitively linked to preeclampsia development.
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