Hyperparathyroidism in Pregnant Women: Clinical Issues, Laboratory Findings and Relevant Therapeutic Approachesr

Abstract

Primary hyperparathyroidism (PHPT) is a disorder that results from hypersecretion of parathyroid hormone (PTH), which is the most common cause of hypercalcemia in the outpatient setting. An analysis published in 2013 showed that the incidence in women of reproductive age, within a racially mixed population, is 4.7-6.2 cases per 100,000 persons [1]. In pregnant women, the disease occurs in 0.5-1.4%, and in 80% it is due to adenoma of the parathyroid glands [2]. When untreated, PHPT can lead to maternal complications such as nephrolithiasis, pancreatitis, and eclampsia, and fetal complications such as low birth weight and neonatal seizure [3-6]. Adequate control of patients who become pregnant with hyperparathyroidism can be a challenge, depending on their clinical symptoms and the laboratory and imaging evaluation. According to the trimester of pregnancy and severity of the disease, the treatment may be either clinical or surgical. The authors present a case of a patient with a pre-pregnancy diagnosis, and a worsening of symptoms during pregnancy; she was referred for surgery due to failure of clinical treatment to keep the disease under control. Case Presentation