Although primary hyperparathyroidism (PHPT) is seen in young women at 8/million ratio, it is more rare to be seen with pregnancy. If diagnosed and not treated during pregnancy, the mother may have nephrolithiasis, hypercalcemic crisis, hypertension, preeclampsia, pancreatitis, death and intrauterine growth retardation in the fetus, low birth weight, preterm delivery, intrauterine death or postpartum tetany. Forty-year-old woman at the 14th week of gestation was diagnosed with Ca: 11,03 (N:8,6−10 mg/dl), P: 2,38 (N: 2,6−4), 5 mg/dl), 25-OH-D: 13.87 (N: 30−80 ng/ml), Parathormone: 141.9 (N: 15−65 pg/ml), creatinine: 0.37 (N: 0.5−0.9 mg/dl), 24 hour urine was Ca: 610 (N: 100−300 mg/24 h). Ultrasonography revealed a parathyroid adenoma in the right lower pole. The patient was diagnosed as primary hyperparathyroidism. The patient was informed about mortality and morbidity and treatment options for PHPT in pregnancy. The patient was operated at the second trimester (17 weeks of gestation). All parathyroids were explored in the operation and the adenoma was removed in the right lower pole. Intraoperative PTH level was found to be 9.47 pg/ml and the operation was terminated. Pathology: Parathyroid adenoma. Postoperative calcitriol 0.5 mg/day, 1×1000 mg calcium was given. On postoperative first day, Ca: 9.71, 8.91 on the second day and 8.87 mg/dl on the fifth day. In patients with parathyroid adenoma in pregnancy, the high complication and mortality rate for the mother and baby can be significantly reduced by the operation of the adenoma in the second trimester.
18 - 21 May 2019
European Society of Endocrinology