Primary Hyperparathyroidism in Pregnancy: A Multicenter Case Series of 4 Patients from Northern India

Excerpt

Primary hyperparathyroidism (PHPT) is third most common endocrine disorder. Middle-aged women suffer three times more than men. The annual incidence of PHPT in pregnancy is around 8 cases per 100,000 of population [1]. The physiological changes during normal pregnancy, like slight drop in serum calcium due to gestational hypoalbuminemia, increased glomerular filtration rate, transplacental transfer and low-normal intact parathyroid hormone (PTH), may obscure the diagnosis. However, ionized calcium levels are similar to that of non-pregnant state. So, PHPT in pregnancy may be more frequent than previously reported. The three major pathological conditions associated with PHPT include parathyroid adenoma, hyperplasia and carcinoma. Approximately, 85% cases of PHPT in pregnancy are due to single adenoma. The symptoms are usually non-specific as they overlap with those of pregnancy. …