A Rare Cause of Hypercalcemic Crisis in Pregnancy- “Uterine Leiomyoma”
DOI:
https://doi.org/10.14744/ajh.84Keywords:
Gestational hypercalcemia, Parathyroid hormone-related protein, uterine leiomyomaAbstract
Hypercalcemia in pregnancy is a rare condition and causes serious maternal and fetal outcomes. A 35-year-old woman presented with itching, nausea, and vomiting at 37 weeks of spontaneous pregnancy. Biochemical examination revealed hypercalcemia with a low parathyroid hormone (PTH) level and normal 25-hydroxyvitamin D level. An abdominal ultrasound (US) revealed a 158 × 151-mm intramural–subserosal myoma located in the left lateral wall of the uterus. Due to progressive hypercalcemia despite isotonic saline infusion, a single session of hemodialysis was performed. The patient underwent a cesarean section and myomectomy, and normocalcemia was achieved following removal of the placenta and myoma. Parathyroid hormone-related protein (PTHrP) secretion by benign tumors is rare and has been reported in association with intestinal and uterine leiomyomas, as well as renal adenomas.
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