Primary hyperparathyroidism presenting as severe hypercalcemia with acute pancreatitis in pregnancy

Abstract

Primary hyperparathyroidism presenting first time with severe hypercalcemia is rare in pregnancy. We report a case of primary hyperparathyroidism due to a cystic parathyroid adenoma presenting as severe hypercalcemia with acute pancreatitis in second trimester of pregnancy. Acute pancreatitis was managed by conservative treatment. Hypercalcemia failed to respond to medical management and ultimately responded to ultrasound-guided ethanol ablation of parathyroid adenoma. The delivery was uneventful and patient continues to remain normocalcemic during follow up. As such, ethanol ablation of parathyroid adenoma may be considered during pregnancy in case of failure of response to medical management and when surgical removal of parathyroid adenoma is not safe.

摘要

由于原发性甲状旁腺功能亢进症在妊娠期首次出现严重的高钙血症是很罕见的。我们报告一例原发性甲状旁腺机能亢进症, 由囊性甲状旁腺腺瘤引起, 在妊娠中期表现为严重的高钙血症并急性胰腺炎。急性胰腺炎采用保守治疗。高钙血症对药物治疗无效, 最终在超声引导下对甲状旁腺腺瘤进行注射无水乙醇消融治疗后显效。分娩过程顺利, 患者在随访期间血钙保持正常。因此, 在妊娠期间, 如果对药物治疗无效, 当手术切除甲状旁腺腺瘤不安全时, 可以考虑对甲状旁腺腺瘤进行无水乙醇消融治疗。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Acute pancreatitis
• hypercalcemia
• parathyroid adenoma
• pregnancy
• primary hyperparathyroidism

Disclosure statement

The authors report no conflicts of interest.