Hypercalcemia Resulting from Necrotizing Leiomyoma in a Pregnant Female
| Autor: | Omar R. Kayaleh, Steve J. Carlan, Mai Vo, Jacqueline Kropf, Jeannie McWhorter, Sarah Cheyney |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Resuscitation medicine.medical_specialty Exploratory laparotomy medicine.medical_treatment Benign tumor Pregnancy medicine Humans Leiomyoma business.industry Cesarean Section General Medicine Articles medicine.disease Surgery Pregnancy Complications medicine.anatomical_structure Vomiting Hypercalcemia Abdomen Calcium Female Differential diagnosis medicine.symptom business |
| Zdroj: | The American Journal of Case Reports |
| ISSN: | 1941-5923 |
| Popis: | Patient: Female, 38-year-old Final Diagnosis: Hypercalcemia resulting from necrotizing leiomyoma in pregnancy Symptoms: Pain Medication: — Clinical Procedure: Cesarean section Specialty: General and Internal Medicine • Obstetrics and Gynecology Objective: Rare disease Background: Hypercalcemic crisis is defined as a serum calcium level >14 mg/dL in a symptomatic patient. While severe hypercalcemia during pregnancy is rare, it poses a life-threatening risk to both mother and fetus. Hypercalcemia in association with a benign tumor such as a leiomyoma is exceedingly rare. Case Report: A 38-year-old primagravida at 31.2 week’s gestation conceived by in vitro fertilization presented to the emergency department for complaints of nausea, vomiting, and epigastric abdominal pain. Her fetal monitor strip was reassuring. A complete metabolic panel on admission was significant for severely elevated calcium of 15.9 mg/dL (8.6–10.3 mg/dL) and an elevated lipase of 1457U/L (11–82 U/L). She was started on aggressive intravenous fluid resuscitation, but became confused and lethargic, unarousable to verbal stimuli, as a result of hypercalcemia. Computed tomography (CT) scan of the abdomen and pelvis revealed a heterogeneously enhancing, placental-appearing soft tissue mass extending posteriorly and to the right that measured 2414 cm. The patient subsequently underwent planned low transverse cesarean delivery and exploratory laparotomy for myomectomy with removal of a 2834-g benign leiomyoma measuring 19.018.514.0 cm. Her serum parathyroid hormone-related protein (PTHrP) was elevated to 9.6 pmol/L ( |
| Databáze: | OpenAIRE |
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