Primary hyperparathyroidism in pregnancy: observations from the Indian PHPT registry

Pal, Rimesh; Bhadada, Sanjay Kumar; Gupta, Nidhi; Behera, Arunanshu; Aggarwal, Neelam; Aggarwal, Aditya; Raviteja, K V; Saikia, Uma Nahar; Kaur, Gurjeet; Arvindbhai, Sapara Mohin; Walia, Rama

doi:10.1007/s40618-020-01441-z

Cited by 22 publications

(32 citation statements)

References 50 publications

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“…PHPT during pregnancy is relatively rare, accounting for roughly 1% of the total PHPT patients (163,164,165). PHPT diagnosed during pregnancy requires consideration of alterations in PTH concentrations and associated changes in mineral metabolism (Fig.…”

Section: Management Of Patients With Phpt In Relation To Pregnancy?mentioning

confidence: 99%

“…PHPT diagnosed during pregnancy requires consideration of alterations in PTH concentrations and associated changes in mineral metabolism (Fig. 6) (163,164,165,166,167,168,169,170,171,172). Distinguishing PHPT from FHH in pregnancy is challenging in view of absorptive hypercalciuria, resulting in a significant increase of the CCCR (173,174).…”

Section: Management Of Patients With Phpt In Relation To Pregnancy?mentioning

confidence: 99%

“…Polyhydramnios may develop due to osmotic polyuria of the fetus (171). The vast majority of investigations on gestational PHPT report on significantly increased risk of fetal/neonatal and maternal complications (163,164,165,166,167,168,169,170,171,172), which might reflect publication bias. In general, calcium levels are usually only slightly elevated and relatively stable, and many cases of mild PHPT go undiagnosed in pregnancy with no particular increase in maternal or fetal health risk (159).…”

Section: Management Of Patients With Phpt In Relation To Pregnancy?mentioning

confidence: 99%

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European expert consensus on practical management of specific aspects of parathyroid disorders in adults and in pregnancy: recommendations of the ESE Educational Program of Parathyroid Disorders (PARAT 2021)

Bollerslev

Rejnmark

Zahn

et al. 2022

European Journal of Endocrinology

122

125

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This European expert consensus statement provides recommendations for the diagnosis and management of primary hyperparathyroidism (PHPT), chronic hypoparathyroidism in adults (HypoPT), and parathyroid disorders in relation to pregnancy and lactation. Specified areas of interest and unmet needs identified by experts at the second ESE Educational Program of Parathyroid Disorders (PARAT) in 2019, were discussed during two virtual workshops in 2021, and subsequently developed by working groups with interest in the specified areas. PHPT is a common endocrine disease. However, its differential diagnosing to familial hypocalciuric hypercalcemia (FHH), the definition and clinical course of normocalcemic PHPT, and the optimal management of its recurrence after surgery represent areas of uncertainty requiring clarifications. HypoPT is an orphan disease characterized by low calcium concentrations due to insufficient PTH secretion, most often secondary to neck surgery. Prevention and prediction of surgical injury to the parathyroid glands are essential to limit the disease-related burden. Long-term treatment modalities including the place for PTH replacement therapy and the optimal biochemical monitoring and imaging surveillance for complications to treatment in chronic HypoPT, need to be refined. The physiological changes in calcium metabolism occurring during pregnancy and lactation modify the clinical presentation and management of parathyroid disorders in these periods of life. Modern interdisciplinary approaches to PHPT and HypoPT in pregnant and lactating women and their newborns children are proposed. The recommendations on clinical management presented here will serve as background for further educational material aimed for a broader clinical audience, and were developed with focus on endocrinologists in training.

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Section: Management Of Patients With Phpt In Relation To Pregnancy?mentioning

confidence: 99%

Section: Management Of Patients With Phpt In Relation To Pregnancy?mentioning

confidence: 99%

Section: Management Of Patients With Phpt In Relation To Pregnancy?mentioning

confidence: 99%

See 1 more Smart Citation

European expert consensus on practical management of specific aspects of parathyroid disorders in adults and in pregnancy: recommendations of the ESE Educational Program of Parathyroid Disorders (PARAT 2021)

Bollerslev

Rejnmark

Zahn

et al. 2022

European Journal of Endocrinology

122

125

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“…However, this recent study did not report on maternal outcomes of preeclampsia. Other recent studies also report lower complications rates and good treatment outcomes when the hypercalcemia is moderate and not severe [1,41].…”

Section: Fetal Consequences Of Hypercalcemiamentioning

confidence: 76%

“…Diagnosing hypercalcemia is challenging during pregnancy, as symptoms such as fatigue or nausea mimic those in early pregnancy. However, longstanding hypercalcemia might induce nephrolithiasis, pancreatitis, and preeclampsia in the mother [1]. Therefore, the occurrence of these diseases during pregnancy should push the physicians to screen for hypercalcemia.…”

Section: Introductionmentioning

confidence: 99%

Hypercalcemia during pregnancy: management and outcomes for mother and child

et al. 2021

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Diagnosing and treating hypercalcemia during pregnancy can be challenging due to both the physiological changes in calcium homeostasis and the underlying cause for the hypercalcemia. During pregnancy and lactation there is increased mobilization of calcium in the mother to meet the fetus’ calcium requirements. Here we discuss the diagnostic challenges, management, and patient perspective of hypercalcemia during pregnancy in two particular cases and in other rare conditions causing hypercalcemia.

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Thyroid and Parathyroid Disease During Pregnancy

Sakr

2024

Head and Neck and Endocrine Surgery

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Primary hyperparathyroidism in pregnancy: observations from the Indian PHPT registry

Cited by 22 publications

References 50 publications

European expert consensus on practical management of specific aspects of parathyroid disorders in adults and in pregnancy: recommendations of the ESE Educational Program of Parathyroid Disorders (PARAT 2021)

European expert consensus on practical management of specific aspects of parathyroid disorders in adults and in pregnancy: recommendations of the ESE Educational Program of Parathyroid Disorders (PARAT 2021)

Hypercalcemia during pregnancy: management and outcomes for mother and child

Thyroid and Parathyroid Disease During Pregnancy

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