Endocrine Abstracts

Until 2002 less than 200 cases of primary hyperparathyroidism identified during pregnancy were reported. We present a case of primary hyperparathyroidism discovered during pregnancy in a 28-year-old woman. The disease was suspected due to a hypercalcemia discovered during a routine blood assessment during pregnancy (calcium=11 mg/dl, phosphorus=2.4 mg/dl). The patient was investigated in the Clinic of Endocrinology and the diagnosis of primary hyperparathyroidism was made on biological investigations: calcium=12.80–15.84 mg/dl, phosphorus=1.06 mg/dl., alkaline phosphatase=428 IU/l, urinary hydroxyproline=118 mg/24 h. Ultrasound neck examination showed a solid formation of 33×18×20 mm. under the lower pole of the right thyroid lobe outside of thyroid tissue. The gestational age was of 30 weeks. The patient was transferred to the 1st. Clinic of Obstetrics and Gynecology and treated with glucocorticoids on order to mature the lung surphactant of the fetus in case of premature labor induced by surgery. At 32 week of gestation the parathyroid adenoma was removed under local anesthesia and confirmed by pathological examination. After resection of the parathyroid adenoma patient’s calcium dropped to 8.5 mg/dl. She gave birth to a healthy newborn at 38 weeks. The patient and her infant were seen after 1 year and both were normal biological parameters. We reported this case because very low incidence of such association and the successful management that prevented the birth of a newborn with severe hypocalcemia due to exposure to hypercalcemia during pregnancy