the biochemical profile of familial hypocalciuric hypercalcemia and primary hyperparathyroidism during pregnancy and lactation: two case reports and review of the literature

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ID: 192882
2016
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Abstract
Background. Primary hyperparathyroidism (PHPT) and Familial Hypocalciuric Hypercalcemia (FHH) result in different maternal and fetal complications in pregnancy. Calcium to creatinine clearance ratio (CCCR) is commonly used to help distinguish these two conditions. Physiological changes in calcium handling during pregnancy and lactation can alter CCCR, making it a less useful tool to distinguish PHPT from FHH. Cases. A 25-year-old female presented with hypercalcemia and an inappropriately normal PTH. Her CCCR was 0.79% before pregnancy and rose to 1.99% in her second trimester. The proband’s mother and neonate had asymptomatic hypercalcemia. Genetic analysis revealed a CaSR mutation consistent with FHH. A 19-year-old female presented with a history of nephrolithiasis who underwent emergent caesarean section at 29 weeks of gestation for severe preeclampsia. At delivery, she was diagnosed with hypercalcemia with an inappropriately normal PTH and a CCCR of 2.67%, which fell to 0.88% during lactation. Parathyroidectomy cured her hypercalcemia. Pathology confirmed a parathyroid adenoma. Conclusion. These cases illustrate the influence of pregnancy and lactation on renal calcium indices, such as the CCCR. To avoid diagnostic error of women with hypercalcemia during pregnancy and lactation, calcium biochemistry of first-degree relatives and genetic testing of select patients are recommended.
Reference Key
ghaznavi2016casethe Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;S. A. Ghaznavi;N. M. A. Saad;L. E. Donovan
Journal chemosensors
Year 2016
DOI
10.1155/2016/2725486
URL
http://dx.doi.org/10.1155/2016/2725486
Keywords
clinical endocrinology diseases of the endocrine glands

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