Liu Xusheng, Li Bo, Liu Jianxiao, Zhao Shengbing
The First Clinical Medical College of Lanzhou University, No. 11, Donggang West Road, Chengguan District, Lanzhou 730000, China.
General Surgery Department, The First Hospital of Lanzhou University, No. 11, Donggang West Road, Chengguan District, Lanzhou 730000, China.
J Surg Case Rep. 2025 Mar 28;2025(4):rjaf161. doi: 10.1093/jscr/rjaf161. eCollection 2025 Apr.
We report a rare case of severe acute pancreatitis with hypercalcaemia induced by primary hyperparathyroidism (PHPT) in a 27-year-old female patient at 28 weeks of gestation during pregnancy. The patient initially presented with onset epigastric pain with nausea and vomiting and was diagnosed with severe acute pancreatitis, hypercalcaemia, and PHPT. After conservative management, the patient underwent a caesarean section and successfully delivered a baby boy, who suffered from hypocalcaemic convulsions in the postnatal period. The patient's blood calcium level was still elevated and subsequently diagnosed as a left parathyroid adenoma by single photon emission computed tomography, and her blood calcium returned to normal after parathyroidectomy. PHPT in pregnancy is often difficult to diagnose early because of the non-specific clinical manifestations. Early recognition and timely surgical treatment are crucial for the safety of the mother and baby. In patients with PHPT with moderate to severe hypercalcaemia, parathyroidectomy is recommended in mid-pregnancy.
我们报告了一例罕见病例，一名27岁女性患者在妊娠28周时因原发性甲状旁腺功能亢进症（PHPT）引发严重急性胰腺炎并伴有高钙血症。患者最初表现为上腹部疼痛伴恶心、呕吐，被诊断为严重急性胰腺炎、高钙血症和PHPT。经过保守治疗后，患者接受了剖宫产手术并成功产下一名男婴，该男婴在出生后出现低钙惊厥。患者血钙水平仍升高，随后通过单光子发射计算机断层扫描诊断为左侧甲状旁腺腺瘤，甲状旁腺切除术后其血钙恢复正常。由于临床表现不具特异性，妊娠期PHPT往往难以早期诊断。早期识别并及时进行手术治疗对母婴安全至关重要。对于患有中度至重度高钙血症的PHPT患者，建议在妊娠中期进行甲状旁腺切除术。
