Nephrolithiasis and primary hyperparathyroidism in pregnancy

Diagnosis of hyperparathyroidism is unusual during pregnancy. The presence of a renal stone is a very exceptional finding. Hypercalcemia is often revealed by standard blood tests. We present here a clinical case of renal nephretic colic occurring during the third trimester of a fourth pregnancy. Our investigations led to the diagnosis of primary hyperparathyroidism which was successfully treated. Hyperparathyroidism during pregnancy is associated with a high incidence of fetal and maternal complications, essentially neonatal hypocalcemia. In utero death is rare but has been reported. Calcium metabolism during pregnancy is dependent on PTHrp. The surgical option is usually taken during the second trimester but can only be proposed during the third trimester in the event of medically resistant hypercalcemia.