Pregnancy Complicated by Concurrent Primary Hyperparathyroidism and Pancreatitis

The third case of pancreatitis and primary hyperparathyroidism during pregnancy is reported. The patient became gravely ill with “hypercalcemic crisis” in the third trimester, the condition was stabilized by medical therapy, and the fetus was delivered when mature. This combined diagnosis is difficult to make because of the changes in calcium metabolism that accompany pregnancy and because of the opposite effects the 2 diseases have on blood calcium levels. In early pregnancy, surgical management of the parathyroid disease seems warranted after the condition has stabilized, whereas in late pregnancy medical treatment may be used and definitive surgery may be postponed until after delivery.