Acute pancreatitis and refractory hypercalcemia in the third trimester caused by parathyroid carcinoma.
BMC Pregnancy Childbirth
; 24(1): 483, 2024 Jul 17.
Article
in En
| MEDLINE
| ID: mdl-39020280
ABSTRACT
BACKGROUND:
Hypercalcemia can be a rare contributor to acute pancreatitis (AP) in pregnancy. This is primarily due to primary hyperparathyroidism (PHPT), resulting from parathyroid carcinoma. We exhibited a case report to analyze the diagnosis and treatment during the onset of hypercalcemia-induced AP. CASE PRESENTATION A 32-year-old primigravida presented with acute pancreatitis near full-term gestation. Following a cesarean delivery, there was a reduction in serum amylase and peripancreatic exudate, but her serum calcium concentrations persistently elevated over 4.0 mmol/L. Interventions to lower the hypercalcemia were only temporarily effective, until a high serum parathyroid hormone (PTH) concentration of 1404 pg/mL was detected. Ultrasound revealed a 31 mm × 24 mm hypoechoic oval nodule in the left lower lobe of the thyroid gland. She underwent a parathyroidectomy, resulting in a dramatic decrease in serum PTH level, from preoperative levels of 2051 pg/mL to 299 pg/mL just 20 minutes after removal. Similarly, her serum calcium declined from 3.82 mmol/L to 1.73 mmol/L within 24 hours postoperatively. The final histopathology suggested parathyroid carcinoma.CONCLUSION:
When refractory hypercalcemia is present, serum PTH levels should be measured to determine PHPT. Parathyroidectomy is the optimal strategy for alleviating hypercalcemia and clarifying the underlying pathology.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pancreatitis
/
Parathyroid Neoplasms
/
Pregnancy Complications, Neoplastic
/
Pregnancy Trimester, Third
/
Parathyroidectomy
/
Hypercalcemia
Limits:
Adult
/
Female
/
Humans
/
Pregnancy
Language:
En
Journal:
BMC Pregnancy Childbirth
Journal subject:
OBSTETRICIA
Year:
2024
Document type:
Article
Affiliation country:
China