February 19th, 2020

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Primary Hyperparathyroidism Mimicking Preeclampsia in Pregnancy: A Case Report
Authors:  Kristina Martimucci, D.O., Robyn Bilinski, M.D., Abdulla Al-Khan, M.D., and Jesus R. Alvarez-Perez, M.D.
BACKGROUND: Primary hyperparathyroidism (PHP) refers to an overactive state of one or more parathyroid glands. Though it is the third most common endocrine disorder, its incidence is extremely rare in pregnancy, especially in the third trimester.

CASE: A 28-year-old primigravid woman was admitted for a workup of suspected preeclampsia at 33 weeks’ gestation after displaying elevated blood pressures and proteinuria. Laboratory evaluation showed an elevated calcium level of 12.2 mg/dL, serum intact parathyroid hormone (PTH) of 113 pg/mL, and proteinuria of 567 mg/day. Imaging aided in the diagnosis of primary hyperparathyroidism secondary to an overactive adenoma. Medical management was unsuccessful; hence, a partial parathyroidectomy was done. Calcium levels, PTH levels, proteinuria, and blood pressure all resolved within 2 weeks after surgery. No neonatal or maternal complications were encountered after delivery.

CONCLUSION: PHP mimicked preeclampsia, with resolution of symptoms after successful parathyroidectomy.
Keywords:  adenoma/complications; adenoma/epidemiology; adenoma/surgery; comorbidity; adult; female; humans; hypercalcemia; hyperparathyroidism; hyperparathyroidism/epidemiology; hyperparathyroidism/surgery; parathyroid gland; parathyroid neoplasms; parathyroidectomy; pre-eclampsia/etiology; preeclampsia; pregnancy; pregnancy complications; pregnancy trimester, third; primary hyperparathyroidism
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