Division of Endocrinology and Metabolism, Department of Internal Medicine MacKay Memorial Hospital, Taipei.
Department of Medicine, MacKay Medical College, New Taipei City.
Medicine (Baltimore). 2021 Apr 9;100(14):e25451. doi: 10.1097/MD.0000000000025451.
Nausea and vomiting are common in the early period of pregnancy and rarely seen as an overture to pancreatitis.
Here, we describe a 31-year-old pregnant woman who presented with progressive nausea and vomiting followed by severe epigastric pain. Biochemical data and sonographic features confirmed the occurrence of acute pancreatitis. Accompanying electrolyte abnormalities included hypercalcemia and hypokalemia. Her condition stabilized following medical treatment, but hypercalcemia persisted despite intravenous fluids and furosemide administration.
A diagnosis of primary hyperparathyroidism was made based on the elevated parathyroid hormone level and urinary calcium-to-creatinine clearance ratio.
Localization study with neck ultrasonography indicated left inferior parathyroid adenoma. She underwent parathyroidectomy successfully and made an uneventful recovery.
At 37 weeks of gestation, she had a serum calcium level of 8.8 mg/dL and normal parathyroid hormone of 28.55 pg/mL. A healthy baby weighing 3180 g was delivered smoothly with no clinical nor biochemical evidence of hypocalcemia.
Although primary hyperparathyroidism during pregnancy is usually asymptomatic, patients may present with atypical manifestations such as hyperemesis and pancreatitis. Proper diagnosis and timely intervention are crucial to minimizing potential hazards to both mother and fetus.
恶心和呕吐在妊娠早期很常见，但很少作为胰腺炎的先兆。
这里，我们描述了一位 31 岁的孕妇，她出现进行性恶心和呕吐，随后出现严重的上腹痛。生化数据和超声特征证实发生了急性胰腺炎。伴随的电解质异常包括高钙血症和低钾血症。经药物治疗后，她的病情稳定，但尽管给予静脉补液和呋塞米，高钙血症仍持续存在。
根据甲状旁腺激素水平升高和尿钙/肌酐清除率比值，诊断为原发性甲状旁腺功能亢进症。
颈部超声检查定位显示左侧下甲状旁腺腺瘤。她成功接受了甲状旁腺切除术，恢复顺利。
在妊娠 37 周时，她的血清钙水平为 8.8mg/dL，甲状旁腺激素正常为 28.55pg/mL。顺利产下一名体重 3180g 的健康婴儿，无低钙血症的临床或生化证据。
尽管妊娠期间原发性甲状旁腺功能亢进症通常无症状，但患者可能表现出非典型症状，如妊娠剧吐和胰腺炎。正确的诊断和及时的干预对于将母婴潜在风险降到最低至关重要。
