Acute pancreatitis and preeclampsia induced by parathyroid sdenoma in pregnancy: a case report and literature review

Primary hyperparathyroidism (PHP) during pregnancy is very rare, and the complications are life threatening and difficult to address. Thus, early diagnosis and appropriate treatment are critical for this disease. We describe a single case of PHP during third trimester pregnancy, which was also combined with hypertension. The patient developed preeclampsia and went into a hypercalcemic crisis; an ultrasound examination found no lesion in the parathyroid gland, and a Cesarean delivery was performed at 31 weeks. After delivery, acute pancreatitis occurred. Subsequently, a second ultrasound and an MRI examination found a mass behind the lower-right thyroid gland, both suggesting parathyroid adenoma. A successful parathyroidectomy was conducted, and the patient was finally cured. Diagnosis of PHP during pregnancy is challenging for the physician. Untreated hypercalcemia can be life-threatening and can induce the onset of preeclampsia, which is a major cause of maternal and fetal mortality. Acute pancreatitis is the third most common complication of PHP, after nephrolithiasis and bone disease, and causes a severe outcome if not treated promptly. Surgery is the gold standard of treatment for PHP during pregnancy, and a parathyroidectomy during the second trimester of pregnancy is considered safe and effective.