{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T14:14:46Z","timestamp":1779718486762,"version":"3.53.1"},"reference-count":10,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Obstet Med"],"abstract":"<jats:p>We report the case of a 32-year-old pregnant woman who presented at 9 weeks of gestation with severe hyperemesis gravidarum (HG) and metabolic disturbances. Biochemical testing revealed hypercalcemia with an inappropriately elevated parathyroid hormone (PTH) level. Subsequent imaging identified a parathyroid adenoma. This case highlights primary hyperparathyroidism as a rare but important differential diagnosis in refractory HG and underscores the diagnostic challenges of interpreting calcium and PTH values during pregnancy.<\/jats:p>","DOI":"10.1177\/1753495x261439643","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T07:57:36Z","timestamp":1779436656000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Refractory hypokalemic metabolic alkalosis in pregnancy: Interplay of hyperemesis gravidarum and primary hyperparathyroidism"],"prefix":"10.1177","author":[{"given":"Anja","family":"Reichelt","sequence":"first","affiliation":[{"name":"University Hospital St P\u00f6lten \u2013 NOE LGA, Karl Landsteiner University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Halmer","sequence":"additional","affiliation":[{"name":"University Hospital St P\u00f6lten \u2013 NOE LGA, Karl Landsteiner University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuel","family":"Rotteneder","sequence":"additional","affiliation":[{"name":"University Hospital St P\u00f6lten \u2013 NOE LGA, Karl Landsteiner University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Staudenherz","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Molecular Imaging and Special Endocrinology, University Hospital, \u2013 NOE LGA, Karl Landsteiner University, St. P\u00f6lten, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Schubert","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, University Hospital St. P\u00f6lten, \u2013 NOE LGA, Karl Landsteiner University, St. P\u00f6lten, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2721-6624","authenticated-orcid":false,"given":"Birgit","family":"Pfaller","sequence":"additional","affiliation":[{"name":"University Hospital St P\u00f6lten \u2013 NOE LGA, Karl Landsteiner University"},{"name":"Karl Landsteiner Institute for Nephrology and Hematooncology, St. P\u00f6lten, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17739"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.03.006"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.4679"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2021.07.009"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/1753495X18766170"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-021-05950-2"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgac734"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-022-02287-w"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-21-1044"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29489"}],"container-title":["Obstetric Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1753495X261439643","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1753495X261439643","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1753495X261439643","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T13:47:04Z","timestamp":1779716824000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1753495X261439643"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,22]]},"references-count":10,"alternative-id":["10.1177\/1753495X261439643"],"URL":"https:\/\/doi.org\/10.1177\/1753495x261439643","relation":{},"ISSN":["1753-495X","1753-4968"],"issn-type":[{"value":"1753-495X","type":"print"},{"value":"1753-4968","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,22]]},"article-number":"1753495X261439643"}}