Primary hyperparathyroidism in pregnancy: a case series and literature review

Abstract

Primary Hyperparathyroidism (PHP) in pregnancy constitutes a serious danger to mother and fetus. The diagnosis of PHP in pregnancy presents a challenge, and PHP commonly goes unidentified and untreated in pregnancy. We present four case reports about patients having PHP, which is very rare condition in pregnancy and their treatment modalities. Three patients, not to be controlled biochemically, denied the parathyroidectomy operation although they are informed about the details of their disease. They are followed up with medical therapy. The first one had no maternal or fetal complications, the second one acquired nephrolithiasis crisis in the last trimester and the third one gave birth to a premature baby who succumbed to tetany. The fourth patient who underwent parathyroidectomy operation in the second trimester had no maternal or fetal complications. PHP in pregnancy is a preventable cause of fetal and maternal mortality and morbidity. Thus, suspecting from PHP during the pregnancy and early diagnosis is critically important in terms of maternal and fetal wellness.

Chinese abstract

妊娠期原发性甲状旁腺功能亢进 (PHP) 严重危害母亲和胎儿的健康。 妊娠期PHP的诊断比较困难, 通常妊娠期PHP不易察觉且未经有效治疗。这里有四份PHP患者的病例报告, 她们处于妊娠期且治疗方式也比较特殊。其中三名患者未进行生化控制, 拒绝甲状旁腺切除术手术, 尽管他们被告知了自身疾病的详细情况。随后他们进行了药物治疗。 其中第一例无母婴并发症, 第二例在妊娠期的后三个月有肾结石的风险, 第三例婴儿早产且死于手足搐搦。第四名在孕中期进行了甲状旁腺切除的患者未发生母婴并发症。妊娠期PHP是可预防的胎儿和母亲发病和死亡的重要因素。因此, 在妊娠期对PHP的关注和PHP的早期诊断对母胎健康至关重要重要。

Keywords:

• Hypercalcemia
• hyperparathyroidism
• pregnancy

Acknowledgements

We thank all hospital officials and employees of Ataturk University as well as patients who are featured in our case series.

Declaration of interest

The authors report no declarations of interest.