Primary Hyperparathyroidism in a Twin Pregnancy: A Case Report

Abstract

The primary hyperparathyroidism during pregnancy is an infrequent disorder but it is rarer in a twin gestation. Often it is not suspected because the symptomatology is overlapped with the normal course of pregnancy and it is usually discovered after a routine blood test. Ultrasound is the best option to identify the adenoma, while the gold-standard is technetium-99 m sestamibi but is contraindicated in this situation. The treatment is controversial and depends of the time of the gestation: the medical therapy is accepted in the first and third trimester, and the surgery is reserved for the second trimester, where the side effects are low. We present a case of primary hyperparathyroidism in a twin pregnancy treated by a minimally invasive parathyroidectomy in the second trimester without consequences for both, mother and newborns.