Hypercalcemia in Pregnancy Caused by a Uterine Myoma.

JCEM case reports Pub Date : 2024-08-14 eCollection Date: 2024-09-01 DOI:10.1210/jcemcr/luae126
Stephanie van der Leij, Doenja Hertog
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Abstract

We present a case of a PTH-related peptide (PTH-rp) producing uterine myoma, leading to hypercalcemia in pregnancy. Our patient presented with dehydration, hypotension, delirium, and malnutrition. Due to a serum calcium level of 17.9 mg/dL (4.48 mmol/L) (reference range 8.8-11.2 mg/dL; 2.20-2.80 mmol/L), prompt treatment with hydration and calcitonin was initiated. The patient went into labor before we could consider other treatment options. Although uncommon in pregnancy, it is of great importance to identify hypercalcemia since it is related to a high risk of maternal and neonatal morbidity and mortality. Because bisphosphonates are contraindicated in pregnancy, hydration and calcitonin are the cornerstones of treatment for PTH-rp-induced hypercalcemia.

子宫肌瘤导致的妊娠高钙血症
我们介绍了一例产生 PTH 相关肽(PTH-rp)的子宫肌瘤,导致妊娠期高钙血症的病例。患者出现脱水、低血压、谵妄和营养不良。由于血清钙水平为 17.9 mg/dL(4.48 mmol/L)(参考值范围为 8.8-11.2 mg/dL;2.20-2.80 mmol/L),我们立即开始了补液和降钙素治疗。在我们考虑其他治疗方案之前,患者已经分娩。虽然高钙血症在妊娠期并不常见,但由于它与孕产妇和新生儿发病率和死亡率的高风险有关,因此识别高钙血症非常重要。由于孕期禁用双膦酸盐,因此水合作用和降钙素是治疗 PTH-rp 引起的高钙血症的基础。
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