Severe acute pancreatitis induced by primary hyperparathyroidism in pregnancy: a case report and literature review

We report a rare case of severe acute pancreatitis with hypercalcaemia induced by primary hyperparathyroidism (PHPT) in a 27-year-old female patient at 28 weeks of gestation during pregnancy. The patient initially presented with onset epigastric pain with nausea and vomiting and was diagnosed with severe acute pancreatitis, hypercalcaemia, and PHPT. After conservative management, the patient underwent a caesarean section and successfully delivered a baby boy, who suffered from hypocalcaemic convulsions in the postnatal period. The patient's blood calcium level was still elevated and subsequently diagnosed as a left parathyroid adenoma by single photon emission computed tomography, and her blood calcium returned to normal after parathyroidectomy. PHPT in pregnancy is often difficult to diagnose early because of the non-specific clinical manifestations. Early recognition and timely surgical treatment are crucial for the safety of the mother and baby. In patients with PHPT with moderate to severe hypercalcaemia, parathyroidectomy is recommended in mid-pregnancy.