Parathyroidectomy in First Trimester of Pregnancy

Sonia G Sharma; Steven N Levine; Rajini K Yatavelli; Manish A Shaha; Cherie Ann O Nathan

doi:10.1210/jendso/bvaa015

Parathyroidectomy in First Trimester of Pregnancy

J Endocr Soc. 2020 Feb 5;4(3):bvaa015. doi: 10.1210/jendso/bvaa015. eCollection 2020 Mar 1.

Authors

Sonia G Sharma¹, Steven N Levine¹, Rajini K Yatavelli¹, Manish A Shaha², Cherie Ann O Nathan²

Affiliations

¹ Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Louisiana State University Health Sciences Center, Shreveport, Louisiana.
² Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana.

Abstract

Primary hyperparathyroidism is not commonly diagnosed during pregnancy. For pregnant women with mild, asymptomatic disease, surgery can be avoided unless the degree of hypercalcemia becomes more severe or they develop complications. However, there are no evidence-based guidelines to assist clinicians regarding the management of primary hyperparathyroidism during pregnancy. When surgery is deemed necessary during pregnancy, the second trimester is generally considered to be the optimal time. We report the case of a 31-year-old female G1P0 who presented at 6 weeks gestation with symptoms of nausea, vomiting, polyuria, and corrected calcium of 14.8 mg/dL. Due to the extreme degree of hypercalcemia and refractory to medical treatment, it was decided that surgery could not be delayed until the second trimester. At 7w3d gestational age the patient had resection of a 37 gram, 5 × 4 × 3 cm right inferior parathyroid adenoma.

Keywords: first trimester; hypercalcemia; hyperparathyroidism; parathyroidectomy; pregnancy.

Publication types

Case Reports