A case of primary hyperparathyroidism during pregnancy.

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The case is a 24-year-old woman who often discharge urinary stones and her laboratory data showed mild decrease of renal function at 24 gestational weeks. Being suspected of primary hyperparathyroidism, we measured her serum level of PTH, calcium and phosphate. Her laboratory data showed high concentrations of serum parathyroid hormone (1.3ng/ml), serum calcium and low concentration of serum phosphate.So she was diagnosed as primary hyperparathyroidism during pregnancy.During pregnancy, hypertension was appeared. But her parathyroid function was not so significantly increased that we followed up only under low calcium diet.At 34 gestational weeks, her parathyroid function was increased and she delivered 1, 900g male baby. In order to prevent from dehydration and calcium crisis, she was given 1, 000ml of physiological saline a day. On the postpartum 37th day, subtotal parathyroidectomy was performed (its histologic type was adenoma). After operation, her serum PTH, calcium and phosphate was nomalized.Meanwhile, serum calcium concentration of newborn was low level and neonatal tetany was appeared, so he was given gluconate calciuml, calcium lactate, 12-OH-D3, and low phosphorus high calcium milk for about 50 days.Because of this therapy, neonatal tetany was disappeared and his serum calcium and phosphate level was normalized.
近畿産科婦人科学会の論文