A Unique Case of Primary Hyperparathyroidism in Pregnancy

Journal of Medical Cases

A 28-year-old Italian woman presented with complains of generalized weakness and vomiting at the 11th week of her pregnancy.She was a booked pregnancy case. The doctors later diagnosed her as primary hyperparathyroidism(PHP).

Increased thyroid hormone blood levels are a usual occurence during pregnancy. However, it is very rare for a pregnant woman to experience a PT disease.

On examination of the patient, she had an increased heart rate. On taking history, the patient revealed no family history of PT disease or renal stones.

Primary Hyperparathyroidism: Investigations

Based on her symptoms, the doctors performed parathyroid (PT) ultrasound and checked her calcium and parathyroid hormone (PTH) levels in the blood. The imaging revealed a mass on the left PT gland. Moreover, the investigations revealed increased serum calcium and PTH hormone levels. Additionally, the doctors performed a biopsy to rule out malignancy. Fortunately, it revealed benign cells.


The doctors labeled her as a case of PHP. Therefore, they commenced the treatment for PHP.

Initial Treatment

The doctors treated her with intravenous fluids. Furthermore, they checked her blood pressure, urine input and output, and body weight regularly.


The doctors performed surgery during her 14th week of pregnancy with the removal of the left PT gland. The causative tumor was parathyroid adenoma. Prior to the removal of the tumor, the patient’s PTH levels were 151 pg/mL. Just 10 mins after removal of the mass, this value fell to 12!

Post-operative care

The patient was given intravenous sodium and calcium within the first 36 hours after surgery. She was then switched to oral calcium which was to be taken twice a day. Moreover, Vitamin D tablets were also given. The postoperative period was smooth with no complications. Thankfully, the patient did not have increased calcium levels in the blood after the gland was removed.


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