A 35-year-old oriental woman, who was 32 weeks pregnant, was hospitalized with suspected preeclampsia. Subsequently, she developed stupor and lethargia. Biochemical assessment showed severe hypercalcemia (21 mg/dl) with undetectable parathyroid hormone (PTH) and markedly elevated PTH-related peptide (PTHrP) levels (26 pmol/l, normal values <1.1 pmol/l). The patientwas treated with i.v. fluid administration, which resulted in an unsatisfactory reduction in serum calcium. Therefore, a cesarean section was performed to deliver the baby. Serum calcium levels promptly normalized after delivery with undetectable PTHrP levels. She delivered a healthy infant only presenting with transient mild jaundice and slightly prolonged QT interval with serum calcium level of 7.8-8.4 mg/dl (corrected for albumin levels). In the subsequent days, the patient developed a transient 'hungry bone' syndrome (calcium 6.7 mg/dl, phosphorous 2.1 mg/dl, and PTH 100.4 pg/ml). In conclusion, this pregnant patient presented with PTHrP-associated hypercalcemia, presumably of placental origin. Delivery resulted in prompt reduction of serum calcium levels and a transient 'hungry bone' syndrome.
|Titolo:||PTHrP-associated hypercalcemia of pregnancy resolved after delivery : a case report|
ELLER VAINICHER, CRISTINA (Primo)
BECK PECCOZ, PAOLO LUIGI MARIA (Penultimo)
|Settore Scientifico Disciplinare:||Settore MED/13 - Endocrinologia|
|Data di pubblicazione:||2012|
|Digital Object Identifier (DOI):||10.1530/EJE-11-1050|
|Appare nelle tipologie:||01 - Articolo su periodico|