Spontaneous fractures secondary to primary hyperparathyroidism in pregnancy: a case report / Fracturas espontâneas secundárias ao hiperparatiroidismo primário na gravidez: um relato de caso

Gabriel Maciel Mendonça, Mariana Costa Marinho Toledo, Guilherme Henrique Santana Mendonça, Laércio Pol-Fachin, Luciano José Ramos Pimentel Santos, Leyna Leite Santos

Abstract


Objective: To report a case of hyperparathyroidism secondary to a parathyroid adenoma, presenting a high level of hypercalcemia associated with spontaneous fractures in young pregnant woman. Case report: The patient underwent an emergency cesarean after presenting premature amniorrhexis and tolerated the procedure without complications. The newborn evolved satisfactorily, without symptoms of hypocalcemia. The postpartum woman was then submitted to left lower parathyroidectomy and, in the postoperative period, she developed bone hunger syndrome, despite previous administration of bisphosphonate. There was a progressive resolution of PTH and serum calcium levels, with a consequent improvement in the clinical condition. Conclusion: This report highlights the need and the difficulty regarding the early diagnosis of primary hyperparathyroidism, which is a potentially fatal pathology for the maternal-fetal binomial. Therefore, it is essential to institute proper treatment early, with individualization according to the patient's clinical condition, to minimize the risks of complications and mortality.  


Keywords


Bone fractures. Cesarean section. Hypercalcemia. Hyperparathyroidism. Parathyroid Neoplasms.

References


Vilar L. Endocrinologia Clínica. Rio de Janeiro: Grupo Gen - Guanabara Koogan; 2016.

Hall JE. Guyton and Hall Textbook of Medical Physiology. Filadélfia: Saunders; 2015.

DiMarco A, Christakis I, Constantinides V, Regan L, Palazzo F. Undiagnosed Primary Hyperparathyroidism and Recurrent Miscarriage: The First Prospective Pilot Study. World J Surg 2018;42(3):639-45.

Zhang Y, Ding J, Yu L, Luo D, Sun J, Lei Z, et al. Twin pregnancy with triple parathyroid adenoma: A case report and review of literature. World J Clin Cases 2018;6(11):466-71.

Yang J, Dong M, Chen F. A rare lethal case of severe acute necrotizing pancreatitis due to a parathyroid adenoma in a third-trimester pregnant woman. BMC Endocr Disord 2019;19(1):82.

Mirza R, Wei E. A Giant Parathyroid Tumor during Pregnancy: Adenoma versus Carcinoma. Case Rep Pathol 2019:4383698.

Lee C-C, Chao A-S, Chang Y-L, Peng H-H, Wang T-H, Chao A. Acute pancreatitis secondary to primary hyperparathyroidism in apostpartum patient: A case report and literature review. Taiwanese J Obstet Gynecol 2014;53(2014)252-5.

Farias ML, Madeira M, Maeda S, Moreira C, Silva D. Guia prático em osteometabolismo. São Paulo: Editora Clannad; 2019.

Herrera-Martínez A, Bahamondes-Opazo R, Palomares-Ortega R, Muñoz-Jiménez C, Gálvez-Moreno M, Quesada Gómez J. Primary Hyperparathyroidism in Pregnancy: A Two-Case Report and Literature Review. Case Rep Obstet Gynecol 2015;2015:171828.

Vitetta G, Neri P, Chiecchio A, Carriero A, Cirillo S, Mussetto A, et al. Role of ultrasonography in the management of patients with primary hyperparathyroidism: retrospective comparison with technetium-99m sestamibi scintigraphy. J Ultrasound 2014;17(1):1-12.

Nascimento GM, Vasconcelos HG, Rodrigues FOS, Faveri LA, Lara LR, Moraes EEC, Castro H, Calixto RC, Cazarotto VT, Viali KHL, Resende DR, Fávero GFC. Hiperparatireoidismo secundário: correlação clínica, laboratorial e radiológica. Braz. J. Develop 2021;7(5):51056-51069.

Tachamo N, Timilsina B, Dhital R, Lynn T, Magaji V, Gabriely I. Primary Hyperparathyroidism in Pregnancy: Successful Parathyroidectomy during First Trimester. Case Rep Endocrinol 2018:5493917.

McCarthy A, Howarth S, Khoo S, Hale J, Oddy S, Halsall D, et al. Management of primary hyperparathyroidism in pregnancy: a case series. Endocrinol Diabetes Metab Case Rep 2019;2019:19-0039.

Rigg J, Gilbertson E, Barrett H, Britten F, Lust K. Primary Hyperparathyroidism in Pregnancy: Maternofetal Outcomes at a Quaternary Referral Obstetric Hospital, 2000 Through 2015. J Clin Endocrinol Diabetes 2019;104(3):721-9.

MacKenzie-Feder J, Sirrs S, Anderson D, Sharif J, Khan A. Primary Hyperparathyroidism: An Overview. Int J Endocrinol 2011:251410.




DOI: https://doi.org/10.34117/bjdv7n9-239

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