Pregnancy complicated by concurrent primary hyperparathyroidism and pancreatitis

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Gastroenterology

Background:

• Pregnancy alters calcium metabolism, complicating diagnosis of hypercalcemic conditions.
• Primary hyperparathyroidism and pancreatitis are rare, especially when co-occurring during gestation.

Observation:

• A pregnant patient presented with severe hypercalcemic crisis in the third trimester.
• The condition was medically stabilized, allowing for the delivery of a mature fetus.

Findings:

• The co-occurrence of pancreatitis and primary hyperparathyroidism in pregnancy presents diagnostic challenges due to conflicting effects on calcium levels.
• Medical management can stabilize hypercalcemic crisis in late pregnancy.

Implications:

• Early pregnancy diagnosis and stabilization followed by surgery for parathyroid disease is recommended.
• In late pregnancy, medical management is preferred, with definitive surgery deferred until postpartum.