Abstract
Primary hyperparathyroidism (PHPT) in pregnant women is an uncommon disease. It could be easily misdiagnosed because of physiologic changes during pregnancy; in some cases, patients could remain asymptomatic maintaining elevated calcium serum levels, and this situation represents a threat to the health of both mother and fetus. We present two cases of PHPT during pregnancy and their evolution after surgical treatment in the second trimester; there were no observed complications during pregnancy or delivery in our patients. Early diagnosis and medical/surgical treatment in PHPT are necessary for avoiding maternal and fetal complications which could not be predicted based on duration or severity of hypercalcemia. An appropriate management of PHPT during pregnancy is necessary for preserving the health of both the woman and the fetus.
Highlights
Primary hyperparathyroidism (PHPT) results from inappropriate overproduction of parathyroid hormone from one or many parathyroid gland(s) [1]
PHPT consists in the presence of elevated serum calcium, low or low-normal phosphate with elevated or inappropriately normal PTH with hypercalciuria
PHPT usually occurs as the result of sporadic parathyroid adenomas or carcinomas, and it can be seen in association with multiple endocrine neoplasias and in rare genetic syndromes or metabolic diseases [1]
Summary
Primary hyperparathyroidism (PHPT) results from inappropriate overproduction of parathyroid hormone from one or many parathyroid gland(s) [1]. It is the third most common endocrine disorder (after diabetes and thyroid disease), and the most common cause of hypercalcemia. It affects 0.3% of the general population, with a twice higher incidence in women [2], and a similar incidence in pregnant and nonpregnant women [3]. Parathyroid hormone(PTH-) mediated bone resorption is inhibited by estrogens, which causes a dose-related reduction in serum calcium in pregnant patients [3]. We present two cases of PHPT during pregnancy and their evolution after surgical treatment
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