Hyperparathyroidism during pregnancy. Is it a diagnostic and therapeutic challenge?

Cir Cir. 2019;87(S1):62-67. doi: 10.24875/CIRU.19000796.

Abstract

Background: Primary hyperparathyroidism (PHPT) is characterized by an increase in parathyroid hormone (PTH) and hypercalcemia, which, when present during pregnancy, increases both maternal and fetal morbidity and mortality.

Objective: Emphasize the importance of surgical intervention in primary hyperparathyroidism during pregnancy.

Clinical case: A 27-year-old female with a pregnancy of 27.2 weeks of gestation, with a diagnosis of symptomatic primary hyperparathyroidism secondary to parathyroid adenoma, a history of nephrolithiasis and severe acute pancreatitis, surgery was decided upon finding intrathyroid right parathyroid adenoma, post-surgical course with adequate evolution and remission of hyperparathyroidism.

Conclusions: Parathyroidectomy in primary hyperparathyroidism during pregnancy is safe.

Introducción: El hiperparatiroidismo primario (HPTP) se caracteriza por un aumento de la hormona paratiroidea (PTH) e hipercalcemia, que aumenta la morbimortalidad materna y fetal cuando se presenta durante el embarazo.

Objetivo: Enfatizar la importancia de la intervención quirúrgica en el hiperparatiroidismo primario durante el embarazo.

Caso clínico: Paciente femenino de 27 años de edad con embarazo de 27.2 semanas de gestación, con diagnóstico de hiperparatiroidismo primario sintomático secundario a adenoma paratiroideo, antecedentes de nefrolitiasis y pancreatitis aguda grave; al decidir realizar un procedimiento quirúrgico se identificó un adenoma paratiroideo derecho intratiroideo; el curso posquirúrgico mostró adecuada evolución y remisión del hiperparatiroidismo.

Conclusión: La paratiroidectomía en el hiperparatiroidismo primario durante el embarazo es segura.

Keywords: Adenoma paratiroideo; Embarazo; Hiperparatiroidismo primario; Hormona paratiroidea; Parathyroid adenoma; Parathyroid hormone; Parathyroidectomy; Paratiroidectomía; Pregnancy; Primary hyperparathyroidism.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adenoma / complications*
  • Adenoma / diagnosis
  • Adenoma / surgery
  • Adult
  • Blood Component Transfusion
  • Calcium / metabolism
  • Carcinoma, Papillary / diagnosis
  • Carcinoma, Papillary / surgery
  • Female
  • Hormones / blood
  • Humans
  • Hypercalcemia / etiology
  • Hyperparathyroidism, Primary / blood
  • Hyperparathyroidism, Primary / etiology*
  • Incidental Findings
  • Nephrolithiasis / etiology
  • Pancreatitis / etiology
  • Parathyroid Neoplasms / complications*
  • Parathyroid Neoplasms / diagnosis
  • Parathyroid Neoplasms / surgery
  • Parathyroidectomy*
  • Pregnancy
  • Pregnancy Complications, Neoplastic / blood
  • Pregnancy Complications, Neoplastic / diagnosis
  • Pregnancy Complications, Neoplastic / surgery*
  • Thyroid Neoplasms / diagnosis
  • Thyroid Neoplasms / surgery
  • Thyroidectomy

Substances

  • Hormones
  • Calcium