Benson Brian C, Guinto Roy E, Parks Jonathan R
Department of Internal Medicine, Tripler Army Medical Center, Honolulu, HI 96859, USA.
Hawaii J Med Public Health. 2013 Jan;72(1):11-3.
Nausea and vomiting are common complaints during pregnancy. Their severity and persistence can lead to the diagnosis of hyperemesis gravidarum, which is associated with weight loss, ketonuria, and decreased fetal birth weight. Hypercalcemia in pregnancy can confound these common gastrointestinal symptoms as well as have its own intrinsic maternal-fetal risks. A 23-year-old woman was diagnosed with primary hyperparathyroidism after multiple visits to the emergency department and the obstetrical clinic with symptoms of nausea and vomiting. Her symptoms were initially attributed to hyperemesis gravidarum and only after multiple hospital visits was her hypercalcemia discovered. Her workup led to the diagnosis of primary hyperparathyroidism caused by a solitary parathyroid adenoma. The patient was treated conservatively with intravenous fluids and eventually surgical resection of the parathyroid adenoma which led to complete resolution of her symptoms. This case demonstrates the diagnostic and therapeutic challenges associated with hyperparathyroidism in pregnancy.
恶心和呕吐是孕期常见的症状。其严重程度和持续时间可能导致妊娠剧吐的诊断,妊娠剧吐与体重减轻、酮尿症以及胎儿出生体重降低有关。孕期高钙血症可能会混淆这些常见的胃肠道症状,同时也有其自身内在的母婴风险。一名23岁女性因恶心和呕吐症状多次前往急诊科和产科诊所就诊后,被诊断为原发性甲状旁腺功能亢进。她的症状最初被归因于妊娠剧吐,直到多次住院后才发现她的高钙血症。进一步检查诊断为由孤立性甲状旁腺腺瘤引起的原发性甲状旁腺功能亢进。该患者接受了静脉补液保守治疗,最终手术切除甲状旁腺腺瘤,症状完全缓解。本病例展示了孕期甲状旁腺功能亢进相关的诊断和治疗挑战。