Hyperparathyroidism in pregnancy: diagnostic dilemma?

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Internal Medicine

Background:

• Primary hyperparathyroidism is uncommon during pregnancy.
• Delayed diagnosis of hyperparathyroidism increases risks for mother and fetus.
• Symptoms overlap with preeclampsia, complicating diagnosis.

Observation:

• A pregnant patient in her third trimester presented with HELLP syndrome.
• The patient also had undiagnosed primary hyperparathyroidism.
• Distinguishing between hyperparathyroidism and preeclampsia symptoms proved challenging.

Findings:

• The case highlights the co-occurrence of HELLP syndrome and primary hyperparathyroidism in pregnancy.
• This presentation underscores diagnostic challenges due to overlapping clinical features.
• Accurate diagnosis is essential for appropriate management.

Implications:

• Emphasizes the need for heightened clinical suspicion for primary hyperparathyroidism in pregnant patients, especially with preeclampsia-like symptoms.
• Suggests considering parathyroid evaluation in pregnant women with severe hypertensive disorders.
• Underscores the importance of timely diagnosis and management to improve maternal and perinatal outcomes.