van der Leij Stephanie, Hertog Doenja
Department of Endocrinology, University Medical Center, Utrecht University, Utrecht, CX 3584, The Netherlands.
Princess Máxima Center for Pediatric Oncology, Utrecht, CS 3584, The Netherlands.
JCEM Case Rep. 2024 Aug 14;2(9):luae126. doi: 10.1210/jcemcr/luae126. eCollection 2024 Sep.
We present a case of a PTH-related peptide (PTH-rp) producing uterine myoma, leading to hypercalcemia in pregnancy. Our patient presented with dehydration, hypotension, delirium, and malnutrition. Due to a serum calcium level of 17.9 mg/dL (4.48 mmol/L) (reference range 8.8-11.2 mg/dL; 2.20-2.80 mmol/L), prompt treatment with hydration and calcitonin was initiated. The patient went into labor before we could consider other treatment options. Although uncommon in pregnancy, it is of great importance to identify hypercalcemia since it is related to a high risk of maternal and neonatal morbidity and mortality. Because bisphosphonates are contraindicated in pregnancy, hydration and calcitonin are the cornerstones of treatment for PTH-rp-induced hypercalcemia.
我们报告一例产生甲状旁腺激素相关肽（PTH-rp）的子宫肌瘤病例，该病例导致妊娠期高钙血症。我们的患者出现脱水、低血压、谵妄和营养不良。由于血清钙水平为17.9mg/dL（4.48mmol/L）（参考范围8.8 - 11.2mg/dL；2.20 - 2.80mmol/L），遂立即开始进行补液和降钙素治疗。在我们考虑其他治疗方案之前，患者进入了分娩期。虽然妊娠期高钙血症并不常见，但识别它非常重要，因为它与母婴发病和死亡的高风险相关。由于双膦酸盐在妊娠期禁用，补液和降钙素是治疗PTH-rp诱导的高钙血症的基石。
