Primary hyperparathyroidism in pregnancy presenting as intractable hyperemesis complicating psychogenic anorexia: a case report.
BACKGROUND
Primary hyperparathyroidism is a rare complication of pregnancy. Its peak incidence is in the perimenopausal period.


METHODS
A 31-year-old woman was admitted at 8 weeks of pregnancy with intractable hyperemesis and fatigue. After parathyroidectomy, at 18 weeks' gestation, she remained asymptomatic. Biochemistry gradually normalized, and her body mass index returned to the levels found prior to her eating disorder manifestation. In our review there were no maternal complications in 32 of 43 (74%) cases. There were 10 cases (21%) of fetal complications identified.


CONCLUSIONS
Postponing treatment increases the risk of preeclampsia, preterm labor and fetal parathyroid impairment, while early surgical treatment decreases the fetal complication rate 4-fold.
Department of Obstetrics and Gynaecology, Queen Mary's Hospital, Sidcup, Kent, UK. pachydakis@hotmail.com
Anastasios
A
Pachydakis
Pelopidas
P
Koutroumanis
Bohaiza
B
Geyushi
Leila
L
Hanna
D000236:Adenoma / Q000150:complications* / Q000601:surgery; D000328:Adult; D000855:Anorexia / Q000209:etiology*; D000856:Anorexia Nervosa / Q000209:etiology; D005260:Female; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000209:etiology*; D049950:Hyperparathyroidism, Primary / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D010282:Parathyroid Neoplasms / Q000150:complications* / Q000601:surgery; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000601:surgery