Spontaneous fractures secondary to primary hyperparathyroidism in pregnancy: a case report / Fracturas espontâneas secundárias ao hiperparatiroidismo primário na gravidez: um relato de caso

Abstract

Objective: To report a case of hyperparathyroidism secondary to a parathyroid adenoma, presenting a high level of hypercalcemia associated with spontaneous fractures in young pregnant woman. Case report: The patient underwent an emergency cesarean after presenting premature amniorrhexis and tolerated the procedure without complications. The newborn evolved satisfactorily, without symptoms of hypocalcemia. The postpartum woman was then submitted to left lower parathyroidectomy and, in the postoperative period, she developed bone hunger syndrome, despite previous administration of bisphosphonate. There was a progressive resolution of PTH and serum calcium levels, with a consequent improvement in the clinical condition. Conclusion: This report highlights the need and the difficulty regarding the early diagnosis of primary hyperparathyroidism, which is a potentially fatal pathology for the maternal-fetal binomial. Therefore, it is essential to institute proper treatment early, with individualization according to the patient's clinical condition, to minimize the risks of complications and mortality.

Atraumatic Fractures in Multi-Morbid Older Adults: A Series of Five Cases and Review of Literature

“…Other hormonal causes of ATF are tumor-induced osteomalacia (FGF-23) and hyperparathyroidism [59,60]. ATF fractures with fracture cascades related to hyperparathyroidism (as in Case 3) were also reported in France and Brazil [61,62].…”