Pancreatitis Secondary to Primary Hyperparathyroidism Complicating Pregnancy

Abstract

Aim: To highlight the need for definitive surgical management of a parathyroid adenoma when associated with pancreatitis during pregnancy. Case Description: 24 year old primi at 28 weeks gestation presented with acute severe pancreatitis which was diagnosed to be secondary to primary hyperparathyroidism. She was first managed medically with calcitonin and then followed by parathyroidectomy during her 31st week. She developed pre-eclampsia in spite of parathyroidectomy. The mother and neonate did not suffer any significant morbidity. Discussion: There is a dearth of information in treating complicated hyperparathyroidism in pregnancy owing to the rarity of such a presentation. There needs to be a consensus regarding its management as most cases reported have significant morbidity and mortality. Medical treatment does not seem to improve this significantly. Advances in surgical methods and the safety of anaesthesia have made surgical management more effective in these antenatal cases. Conclusion: Pancreatitis secondary to hyperparathyroidism during pregnancy should be treated with surgery and medical management restricted to tide over the acute phase of the disease process.