{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T23:36:30Z","timestamp":1781566590192,"version":"3.54.5"},"reference-count":19,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,2,4]]},"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:p>Hyperparathyroidism is a rare disease during pregnancy, which has increased risks, including miscarriage and fetal growth restriction. However, the diagnosis of hyperparathyroidism is frequently not recognised or delayed as symptoms are non-specific and calcium is not routinely measured. With a thorough medical history and clinical suspicion, early diagnosis and treatment can reduce the risk of some pregnancy complications. A 35-year-old woman presented at 13\/40 with hyperemesis gravidarum. She had elevated serum calcium and a parathyroid lesion on ultrasound. She underwent a parathyroidectomy with rapid normalisation of her calcium. Histopathology confirmed a parafibromin-deficient parathyroid tumour, suggestive of hyperparathyroidism jaw tumour syndrome. At 30\/40, she presented with pre-eclampsia (hypertension, hyper-reflexia, proteinuria and intrauterine growth restriction) and had a caesarean section at 30+1\/40, delivering a male infant, 897\u2009g (fifth percentile). She had a prior 12-month history of chronic constipation and nephrolithiasis but was not investigated further despite elevated calcium (2.82\u2009mmol\/L).<\/jats:p>","DOI":"10.1136\/bcr-2019-232653","type":"journal-article","created":{"date-parts":[[2020,2,17]],"date-time":"2020-02-17T03:59:24Z","timestamp":1581911964000},"page":"e232653","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Hyperparathyroidism in pregnancy"],"prefix":"10.1136","volume":"13","author":[{"given":"Catherine","family":"Davis","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health, The University of Sydney Northern Clinical School, St Leonards, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya","family":"Nippita","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, The University of Sydney Northern Clinical School, St Leonards, New South Wales, Australia"},{"name":"Department of Obstetrics and Gynaecology, Royal North Shore Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,2,16]]},"reference":[{"key":"2025082801584637000_13.2.e232653.1","doi-asserted-by":"crossref","first-page":"2115","DOI":"10.1210\/jc.2015-1110","article-title":"Pregnancy outcomes in women with primary hyperparathyroidism","volume":"100","author":"Hirsch","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"key":"2025082801584637000_13.2.e232653.2","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1002\/ccr3.646","article-title":"Hypercalcemia in pregnancy - a multifaceted challenge: case reports and literature review","volume":"4","author":"Rey","year":"2016","journal-title":"Clin Case Rep"},{"key":"2025082801584637000_13.2.e232653.3","doi-asserted-by":"publisher","DOI":"10.1080\/09513590400002334"},{"key":"2025082801584637000_13.2.e232653.4","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1097\/PAS.0000000000001017","article-title":"Parafibromin-deficient (HPT-JT type, CDC73 mutated) parathyroid tumors demonstrate distinctive morphologic features","volume":"43","author":"Gill","year":"2019","journal-title":"Am J Surg Pathol"},{"key":"2025082801584637000_13.2.e232653.5","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1016\/j.fertnstert.2012.08.017","article-title":"Aromatase inhibitor treatment of menorrhagia and subsequent pregnancy in a patient with familial hyperparathyroidism-jaw tumor syndrome","volume":"98","author":"Wolff","year":"2012","journal-title":"Fertil Steril"},{"key":"2025082801584637000_13.2.e232653.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2004.01421.x"},{"key":"2025082801584637000_13.2.e232653.7","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1007\/s00404-014-3297-2","article-title":"Hyperparathyroid crisis presenting with hyperemesis gravidarum","volume":"290","author":"Y\u0131lmaz","year":"2014","journal-title":"Arch Gynecol Obstet"},{"key":"2025082801584637000_13.2.e232653.8","doi-asserted-by":"crossref","first-page":"e31","DOI":"10.1097\/MPA.0000000000000577","article-title":"Hypercalcemic pancreatitis triggered by pregnancy with a CYP24A1 mutation","volume":"45","author":"Kwong","year":"2016","journal-title":"Pancreas"},{"key":"2025082801584637000_13.2.e232653.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2008.03495.x"},{"key":"2025082801584637000_13.2.e232653.10","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-13-0966"},{"key":"2025082801584637000_13.2.e232653.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1996.tb02052.x"},{"key":"2025082801584637000_13.2.e232653.12","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2014-208829","article-title":"Primary hyperparathyroidism in pregnancy leading to hypercalcaemic crisis and uraemic encephalopathy","volume":"2015","author":"Nash","year":"2015","journal-title":"BMJ Case Rep"},{"key":"2025082801584637000_13.2.e232653.13","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s00404-014-3526-8","article-title":"Primary hyperparathyroidism during pregnancy","volume":"291","author":"Dochez","year":"2015","journal-title":"Arch Gynecol Obstet"},{"key":"2025082801584637000_13.2.e232653.14","first-page":"2029","article-title":"Effects of maternal bisphosphonate use on fetal and neonatal outcomes","volume":"71","author":"Green","year":"2014","journal-title":"Am J Helath-Syst Pharm"},{"key":"2025082801584637000_13.2.e232653.15","doi-asserted-by":"crossref","unstructured":"Machairiotis N , Ntali G , Kouroutou P , et al . Clinical evidence of the effect of bisphosphonates on pregnancy and the infant. Horm Mol Biol Clin Investig 2019;40. doi:doi:10.1515\/hmbci-2019-0021. [Epub ahead of print: 20 Sep 2019].","DOI":"10.1515\/hmbci-2019-0021"},{"key":"2025082801584637000_13.2.e232653.16","unstructured":"In Denosumab . DRUGDEX [database on the Internet]. Greenwood Village (CO): Thomson Micromedex. Available: www.micromedexsolutions.com [Accessed 24 Jan 2020]."},{"key":"2025082801584637000_13.2.e232653.17","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-013-9980-4"},{"key":"2025082801584637000_13.2.e232653.18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2018\/5493917","article-title":"Primary hyperparathyroidism in pregnancy: successful parathyroidectomy during first trimester","volume":"2018","author":"Tachamo","year":"2018","journal-title":"Case Rep Endocrinol"},{"key":"2025082801584637000_13.2.e232653.19","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1016\/j.beem.2018.09.006","article-title":"Non-surgical management of primary hyperparathyroidism","volume":"32","author":"Cetani","year":"2018","journal-title":"Best Pract Res Clin Endocrinol Metab"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-232653","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:58:54Z","timestamp":1756371534000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-232653"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2]]},"references-count":19,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,2,16]]},"published-print":{"date-parts":[[2020,2]]}},"alternative-id":["10.1136\/bcr-2019-232653"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-232653","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2]]}}}