Recurrent pancreatitis induced by hyperparathyroidism in pregnancy.
BACKGROUND
As primary hyperparathyroidism affects mainly middle-aged and elderly women, it is an infrequent finding during gestation and breastfeeding. To date, less than 200 pregnant patients with primary hyperparathyroidism diagnosed during pregnancy have been described. Like in other disorders of the parathyroid gland, the recognition of primary hyperparathyroidism during pregnancy and lactation may be difficult, as clinical symptoms are not specific, while laboratory findings may be masked by some typical pregnancy-induced changes in calcium and phosphate homeostasis. If remains untreated, the disease may result in serious clinical implications for the mother and fetus. Most authors consider surgery within the second trimester of pregnancy as the treatment of choice in this group of patients.


METHODS
In our paper, we discuss the case of a 35-year-old female with a history of recurrent acute pancreatitis and recurrent abortions. As the patient declined surgery, conservative management with calcitonin was started and continued throughout the rest of pregnancy, and led to giving birth to the infant whose only health problem was transient hypocalcemia.


CONCLUSIONS
The described case shows that conservative management, if started respectively early and conducted on the basis of a patient's condition, may effectively reduce increased perinatal and maternal morbidity and mortality in pregnant women declining surgery.
Krysiak
Robert
R
Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland. r.krysiak@interia.pl
Wilk
Mariusz
M
Okopien
Bogusław
B
D000026:Abortion, Habitual; D000236:Adenoma / Q000150:complications* / Q000601:surgery; D000328:Adult; D002116:Calcitonin / Q000627:therapeutic use; D002125:Calcium Gluconate / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000151:congenital / Q000188:drug therapy / Q000209:etiology; D006961:Hyperparathyroidism / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D007231:Infant, Newborn; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D010282:Parathyroid Neoplasms / Q000150:complications* / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D012008:Recurrence
C028815:salmon calcitonin; D002116:Calcitonin; D002125:Calcium Gluconate