Preeclampsia: A Possible Complication of Primary Hyperparathyroidism

Area of Science:

• Endocrinology
• Obstetrics
• Surgery

Background:

• Primary hyperparathyroidism is a rare condition during pregnancy.
• A potential association between primary hyperparathyroidism and preeclampsia has been noted in limited global cases.
• This case highlights the importance of considering hyperparathyroidism in pregnant patients presenting with hypertensive disorders.

Purpose of the Study:

• To report a rare case of primary hyperparathyroidism in pregnancy.
• To emphasize the association between primary hyperparathyroidism and preeclampsia.
• To underscore the significance of early diagnosis and management.

Main Methods:

• A case report of a 28-year-old pregnant woman (27 weeks gestation) with severe hypertension.
• Diagnostic workup included blood pressure monitoring, adjusted calcium and parathyroid hormone (PTH) levels, and neck ultrasonography.
• Management involved intravenous hydration, emergency cesarean delivery, and surgical excision of parathyroid adenoma.

Main Results:

• The patient presented with severe hypertension (194/115 mmHg) and incidentally discovered hypercalcemia and elevated PTH.
• Neck ultrasound confirmed a parathyroid adenoma.
• The patient developed preeclampsia-like symptoms, necessitating emergency cesarean delivery and adenoma removal.
• Both mother and neonate had unremarkable recovery post-intervention.

Conclusions:

• Early recognition of primary hyperparathyroidism in pregnant women with preeclampsia is vital.
• Prompt diagnosis and surgical intervention can prevent significant maternal and fetal morbidity and mortality.
• This case underscores the need for vigilance in managing pregnant patients with hypertensive conditions and potential endocrine abnormalities.