title: Hyperparathyroid crisis presenting with hyperemesis gravidarum.
abstract: OBJECTIVE
  Primary hyperparathyroidism during pregnancy is a rare condition, and the diagnosis may be confounded by pregnancy related conditions. Since the appropriate management reduces the maternal and fetal complications; differential diagnosis becomes quite crucial.
  
  
  METHODS
  Clinical course of a patient with hyperparathyroid crisis will be discussed with the review of the literature. A 22-year- old, (gravida 2, para 1) woman was presented with hyperparathyroid crisis at the 11th weeks' gestation. She was hospitalized twice due to hyperemesis gravidarum. When she was admitted to the hospital for the third time due to increased vomiting and weight-loss, serum biochemistry panel was performed and it revealed severe hypercalcemia that serum Ca was 17.59 mg/dl, and she was referred to our hospital as parathyroid crisis. Maternal hypercalcemia was resolved after urgent parathyroidectomy. She was diagnosed as preeclampsia at the 30 weeks' gestation and delivered a male infant weighing 1,090 g at 33 weeks' gestation with APGAR scores 6 at 1 min, and 7 at min 5, without evidence of neonatal hypocalcemia or tetany.
  
  
  RESULTS
  Urgent parathyroidectomy is the definite treatment in symptomatic patients with hyperparathyroidism during pregnancy. Resolving maternal hypercalcemia prevents neonatal tetany and hypocalcemia.
  
  
  CONCLUSIONS
  Hyperemesis may lead to hypercalcemic crisis in patients with hyperparathyroidism, so serum Ca level should be checked in patients with hyperemesis gravidarum especially who detoriate rapidly. Although they share some common pathogenetic mechanisms, there is not enough evidence for attributing preeclampsia to primary hyperparathyroidism.
authors.affiliation: Department of Endocrinology and Metabolism, Gazi University School of Medicine, Ankara, Turkey, baktasyilmaz@yahoo.com.
authors.forename: Banu Aktaş
authors.initials: BA
authors.lastname: Yilmaz
authors.forename: Mustafa
authors.initials: M
authors.lastname: Altay
authors.forename: Ceyla Konca
authors.initials: CK
authors.lastname: Değertekin
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Çimen
authors.forename: Özlem Turhan
authors.initials: ÖT
authors.lastname: Iyidir
authors.forename: Aydan
authors.initials: A
authors.lastname: Biri
authors.forename: Osman
authors.initials: O
authors.lastname: Yüksel
authors.forename: Füsun Baloş
authors.initials: FB
authors.lastname: Törüner
authors.forename: Metin
authors.initials: M
authors.lastname: Arslan
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology / Q000628:therapy; D006939:Hyperemesis Gravidarum / Q000209:etiology*; D049950:Hyperparathyroidism, Primary / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D007231:Infant, Newborn; D008297:Male; D010282:Parathyroid Neoplasms / Q000175:diagnosis / Q000601:surgery; D016105:Parathyroidectomy; D011225:Pre-Eclampsia; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000601:surgery; D055815:Young Adult