Hession Paul, Walsh Jennifer, Gaffney Geraldine
University Hospital Galway, Galway, Ireland.
BMJ Case Rep. 2014 Jan 27;2014:bcr2013202883. doi: 10.1136/bcr-2013-202883.
Two women suffering from primary hyperparathyroidism in pregnancy are presented. Patient 1 with a history of four miscarriages, an ectopic pregnancy and a sixth pregnancy complicated by severe early onset preeclampsia. She was found to have high serum Ca(2+) levels after delivery and parathyroid adenoma was diagnosed by ultrasound. A right inferior parathyroidectomy was performed. Patient 2 with a history of high serum Ca(2+) and generalised symptoms of hypercalcaemia. Ultrasound did not reveal adenoma but an elective neck exploration was performed in light of the abnormal blood results. The right inferior parathyroid gland was excised and histology confirmed the presence of adenoma. These cases help highlight the different ways in which primary hyperparathyroidism can present and the barriers to diagnosis in pregnancy. Various potential complications (including miscarriage and preeclampsia) are explored and the appropriateness of surgical treatment during pregnancy is emphasised.
本文介绍了两名患有原发性甲状旁腺功能亢进症的孕妇。患者1有四次流产、一次异位妊娠史，第六次妊娠并发严重早发型子痫前期。产后发现她血清Ca(2+)水平升高，超声诊断为甲状旁腺腺瘤。行右下甲状旁腺切除术。患者2有血清Ca(2+)水平升高及高钙血症全身症状史。超声未发现腺瘤，但鉴于血液检查结果异常，进行了择期颈部探查。切除右下甲状旁腺，组织学证实存在腺瘤。这些病例有助于突出原发性甲状旁腺功能亢进症的不同表现方式以及孕期诊断的障碍。探讨了各种潜在并发症（包括流产和子痫前期），并强调了孕期手术治疗的适宜性。
