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Hyperparathyroidism complicating pregnancy: a diagnostic challenge?
S N Jibhkate1, A G Valand, S Ansari
1Department of Pathology, Grant Medical College, Mumbai, Maharashtra, India.
Journal of Postgraduate Medicine
|August 15, 2014
Summary
Primary hyperparathyroidism (PHPT) is a rare cause of pancreatitis, especially during pregnancy. This case highlights the severe, fatal complications of undiagnosed PHPT in the postpartum period.
Area of Science:
- Endocrinology
- Obstetrics
- Pathology
Background:
- Primary hyperparathyroidism (PHPT) is an uncommon cause of hypercalcemia-induced pancreatitis, affecting 0.4%-1.5% of the general population and up to 13% of pregnant individuals.
- Diagnosing PHPT during pregnancy is difficult due to physiological calcium homeostasis changes masking hypercalcemia symptoms.
- Untreated PHPT in pregnancy can lead to severe maternal and fetal complications.
Observation:
- A 24-year-old woman was diagnosed with PHPT postpartum.
- She experienced fatal complications on day 20 postpartum.
Findings:
- Pathological examination revealed metastatic calcification in the lungs, pancreas, and uterine vessels.
- Chronic pancreatitis and renal cortical necrosis were also noted.
Implications:
- This case underscores the critical need for timely PHPT diagnosis and management during pregnancy.
- Aggressive treatment, often surgical intervention in the second trimester, is crucial to prevent severe maternal and fetal outcomes.
- Delayed diagnosis can result in catastrophic, life-threatening complications.
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