Vera Lara, Oddo Silvia, Di Iorgi Natascia, Bentivoglio Giorgio, Giusti Massimo
Department of Internal Medicine, Genoa University, Viale Benedetto XV 6, 16132, Genoa, Italy.
Department of Pediatrics, IRCC G. Gaslini, Genoa, Italy.
J Med Case Rep. 2016 Dec 20;10(1):361. doi: 10.1186/s13256-016-1093-2.
The efficacy and safety of various modes of medical treatment for primary hyperparathyroidism in pregnancy are largely unknown.
We report the case of a 34-year-old white woman with primary hyperparathyroidism symptomatic for nephrolithiasis. Her serum calcium was 3.15 mmol/l and parathyroid hormone was 109.0 ng/L. Neck imaging found no pathological parathyroid tissue. Cinacalcet and cholecalciferol were started. She became pregnant 17 months later. The calcimimetic was stopped. During pregnancy, she was admitted for hydration administered intravenously two to three times per week. In her 24 week of pregnancy, cinacalcet was restarted. In her 32nd week, a cesarean section was carried out as planned.
Only three cases of primary hyperparathyroidism in women on cinacalcet therapy in pregnancy have been published in the literature. In the present case, hydration was useful in controlling serum calcium. Cinacalcet therapy helped to control serum calcium.
孕期原发性甲状旁腺功能亢进症的各种治疗方式的疗效和安全性在很大程度上尚不清楚。
我们报告了一例34岁的白人女性，患有因肾结石而出现症状的原发性甲状旁腺功能亢进症。她的血清钙为3.15 mmol/l，甲状旁腺激素为109.0 ng/L。颈部影像学检查未发现病理性甲状旁腺组织。开始使用西那卡塞和胆钙化醇治疗。17个月后她怀孕了。停用了拟钙剂。孕期，她每周接受两到三次静脉补液治疗。怀孕24周时，重新开始使用西那卡塞。怀孕32周时，按计划进行了剖宫产。
文献中仅发表了3例孕期接受西那卡塞治疗的女性原发性甲状旁腺功能亢进症病例。在本病例中，补液有助于控制血清钙。西那卡塞治疗有助于控制血清钙。
