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一例因甲状旁腺腺瘤导致妊娠合并原发性甲状旁腺功能亢进的病例。

A Case of Pregnancy Complicated by Primary Hyperparathyroidism Due to a Parathyroid Adenoma.

作者信息

Mokrysheva Natalia G, Eremkina Anna K, Mirnaya Svetlana S, Rozhinskaya Lyudmila Y, Kuznetsov Nikolay S, Yesayan Rosa M, Kan Natalia E, Dudinskaya Ekaterina N

机构信息

Department of Parathyroid Gland Pathology, Endocrinology Research Center, The Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation.

Department of Neuroendocrinology and Bone Disease, Endocrinology Research Center, The Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation.

出版信息

Am J Case Rep. 2019 Jan 14;20:53-59. doi: 10.12659/AJCR.912436.

Abstract

BACKGROUND Primary hyperparathyroidism is most common in women during the menopause and its occurrence in pregnant women is rare. However, because neonatal mortality is associated with maternal hyperparathyroidism, early diagnosis is essential. This report describes the case of a late diagnosis of primary hyperparathyroidism in a 28-year-old pregnant woman and describes the effects on the mother and neonate. CASE REPORT During her second pregnancy, a 28-year-old woman presented with symptoms of general weakness, bone and joint pain, multiple fractures with bone deformity, muscle weakness, and gait disturbance. Due to the high risk of perinatal pathology, a cesarean section was performed. Several weeks later, she underwent thoracoscopic removal of an ectopic parathyroid gland located at the aortic arch. Hypocalcemia in the newborn infant required treatment with calcium and magnesium supplements. CONCLUSIONS This case demonstrates that primary hyperparathyroidism during pregnancy requires timely diagnosis and treatment to reduce potential maternal and fetal complications. Screening for primary hyperparathyroidism should be undertaken in pregnant women with any symptoms associated with hypercalcemia. Treatment should be individualized and includes conservative management, parathyroidectomy in the second trimester, or parathyroidectomy performed in the early postpartum period.

摘要

背景

原发性甲状旁腺功能亢进在绝经后女性中最为常见,而在孕妇中发生较为罕见。然而,由于新生儿死亡率与母亲甲状旁腺功能亢进有关,早期诊断至关重要。本报告描述了一名28岁孕妇原发性甲状旁腺功能亢进的延迟诊断病例,并描述了对母亲和新生儿的影响。病例报告:一名28岁女性在第二次怀孕期间出现全身无力、骨关节疼痛、多处骨折伴骨骼畸形、肌肉无力和步态障碍等症状。由于围产期病理风险高,进行了剖宫产。几周后,她接受了胸腔镜手术切除位于主动脉弓的异位甲状旁腺。新生儿低钙血症需要补充钙和镁进行治疗。结论:该病例表明,孕期原发性甲状旁腺功能亢进需要及时诊断和治疗,以减少潜在的母婴并发症。对于有任何高钙血症相关症状的孕妇,应进行原发性甲状旁腺功能亢进的筛查。治疗应个体化,包括保守治疗、孕中期甲状旁腺切除术或产后早期甲状旁腺切除术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d3c/6340266/1742d91b4303/amjcaserep-20-53-g001.jpg

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