Treatment approach for primary hyperparathyroidism in pregnancy

Latif, Azka; Gastelum, Alheli Arce; Farhan, Kinaan; Jagadesh, Sunil; Mutnuri, Sangeeta

doi:10.1080/08998280.2020.1834791

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…In several cases, cinacalcet was not well tolerated due to nausea (a known side effect of cinacalcet) ( 6 , 8 , 9 , 12 ). In other cases, cinacalcet lowered but did not normalize serum calcium, and parathyroidectomy was performed at gestational week 14 ( 8 ), 32 ( 10 ), 34 ( 13 ), or 37 ( 14 ), or postpartum ( 7 , 9 , 11 , 12 ). In contrast, our patient had normalization in serum calcium with a lower cinacalcet dose, 30 mg/day, without side effects.…”

Section: Discussionmentioning

confidence: 99%

Use of Cinacalcet for the Management of Primary Hyperparathyroidism in Pregnancy

Foster,

Maalouf

2024

JCEM Case Reports

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Primary hyperparathyroidism in pregnancy is uncommon. Consequently, there are no randomized controlled studies that address treatment of primary hyperparathyroidism in pregnancy, and the efficacy and safety of medical management with cinacalcet in this setting is unknown. We report a case of a 28-year-old woman with primary hyperparathyroidism and hypercalcemia that worsened during her third trimester of pregnancy. Cinacalcet led to achievement of normocalcemia, allowing the delay of parathyroidectomy until after delivery of the baby. We also review the published literature on cinacalcet use in the management of primary hyperparathyroidism during pregnancy. Cinacalcet is typically reserved for pregnant patients with severe and symptomatic hypercalcemia, primarily serving as a last resort to delay parathyroidectomy until either the second trimester or the postpartum period.

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Section: Discussionmentioning

confidence: 99%

Use of Cinacalcet for the Management of Primary Hyperparathyroidism in Pregnancy

Foster,

Maalouf

2024

JCEM Case Reports

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“…She then underwent a left inferior parathyroidectomy on the 7th day of hospitalization and was discharged on the 10th day with normal serum calcium levels. The newborn required a short stay in the neonatal intensive care unit due to hypoglycemia but was reported to be doing well (3).…”

Section: Implication For Health Policy/practice/research/ Medical Edu...mentioning

confidence: 99%

Hyperparathyroidism during pregnancy, a mini review to complications and treatments

Sharafeddin,

Goudarzi

2023

J Parathyr Dis

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Hyperparathyroidism (HPT) is one of the most common endocrine disorders, however it is a rare disease during pregnancy with notable maternal and fetal morbidity and mortality. We investigated 46 articles in PubMed database that seven articles focused on this topic. This review will examine the maternal and neonatal complications and the options for managing and treating this disease during pregnancy.

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“…On the basis of this evidence, the authors concluded that parathyroidectomy is associated with fewer risks and better fetal outcomes than more conservative treatments [43]. A number of experts suggest surgery in the second trimester for all pregnant patients with pHPT regardless of the maternal serum calcium concentrations [19,34,[44][45][46][47]. Based on a study by Norman and colleagues, who observed that calcium levels higher than 2.85 mmol/L were associated with a particularly high risk of fetal loss [26], some authors recommended surgical treatment when calcium levels are above 2.75 mmol/L, especially for patients with recurrent miscarriages [4,23,[48][49][50].…”

Section: Management Of Primary Hyperparathyroidism During Pregnancymentioning

confidence: 99%

“…Parathyroidectomy is classically performed during the second trimester because of incomplete organogenesis in the first trimester and the risk of triggering preterm labor in the third trimester, although some reports of uncomplicated surgery in the third trimester have been published [ 22 , 47 , 49 , 52 , 53 , 54 , 55 ] ( Table 1 ). If a parathyroid adenoma can be localized preoperatively, minimally invasive parathyroidectomy may be performed using a cervical plexus block, thus avoiding general anesthesia [ 45 , 56 , 57 , 58 , 59 ].…”

Section: Disorders Of Calcium and Parathyroid Physiology During Pregnancy And Lactationmentioning

confidence: 99%

Parathyroid Disease in Pregnancy and Lactation: A Narrative Review of the Literature

Tsourdi

Anastasilakis

2021

Biomedicines

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Pregnancy and lactation are characterized by sophisticated adaptations of calcium homeostasis, aiming to meet fetal, neonatal, and maternal calcium requirements. Pregnancy is primarily characterized by an enhancement of intestinal calcium absorption, whereas during lactation additional calcium is obtained through resorption from the maternal skeleton, a process which leads to bone loss but is reversible following weaning. These maternal adaptations during pregnancy and lactation may influence or confound the presentation, diagnosis, and management of parathyroid disorders such as primary hyperparathyroidism or hypoparathyroidism. Parathyroid diseases are uncommon in these settings but can be severe when they occur and may affect both maternal and fetal health. This review aims to delineate the changes in calcium physiology that occur with pregnancy and lactation, describe the disorders of calcium and parathyroid physiology that can occur, and outline treatment strategies for these diseases in the above settings.

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Treatment approach for primary hyperparathyroidism in pregnancy

Cited by 5 publications

References 15 publications

Use of Cinacalcet for the Management of Primary Hyperparathyroidism in Pregnancy

Use of Cinacalcet for the Management of Primary Hyperparathyroidism in Pregnancy

Hyperparathyroidism during pregnancy, a mini review to complications and treatments

Parathyroid Disease in Pregnancy and Lactation: A Narrative Review of the Literature

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