A Fatal Case of Metastatic Pulmonary Calcification during the Puerperium

Abstract

We present an unusual case of a fatal respiratory failure in a young woman developed two weeks after she gave birth at home. Circumstantial and clinical features of the case were strongly suggestive for a ‘classical’ septic origin of the respiratory symptoms. Autopsy, together with histopathological and immunohistochemical analyses allowed demonstrating a massive calcium redistribution consisting of an important osteolysis, especially from cranial bones and abnormal accumulation in lungs and other organs. Such physiopathology was driven by a primary hyperparathyroidism secondary to a parathyroid carcinoma as demonstrated by immunohistochemistry. This very rare case is furthermore characterised by a regular pregnancy course, ended with the birth of a healthy new-born. A complex interaction between pregnancy physiology and hyperparathyroidism might be hypothesised, determining the discrepancy between the relative long period of wellness and the tumultuous cascade occurred in the puerperium.

Pathogenesis of Pregnancy-Related Complications

“…Chighine et al [ 18 ] presented a very rare case of a fatal respiratory failure two weeks after the delivery of a healthy newborn at home in a woman with normal course of gestation who suffered from a primary hyperparathyroidism secondary to a parathyroid carcinoma.…”