Abstract
Hyperparathyroidism during pregnancy is very rare but is associated with high rates of miscarriage, stillbirth, premature birth and neonatal tetany. A 38-year-old woman developed a slight fever and felt unwell ; hypercalcemia with an elevated intact PTH was detected. She was diagnosed as having primary hyperparathyroidism induced by parathyroid hyperplasia ; tumor involving both lower parathyroid glands was detected on ultrasonography and 99mTc-MIBI scintigraphy. The patient refused immediate surgery. Then, 21 months later, in the 24th week of pregnancy, she underwent total parathyroidectomy with intramuscular autotransplantation of parathyroid tissue and safely gave birth to a baby girl 4 months later ; currently, the patient and her daughter are both healthy with normal serum calcium levels 16 months postoperatively. In pregnant women the serum calcium level is usually at the lower limit. Therefore primary hyperparathyroidism should be considered in pregnant women with hypercalcemia. Surgery is safe to do in the second trimester of pregnancy.
