Zusammenfassung
Eine 31-jährige schwangere Patientin entwickelte in der 15. Schwangerschaftswoche eine unstillbare Hyperemesis gravidarum bei schwerer Hyperkalzämie infolge eines metastasierten neuroendokrinen Tumors. Eine Octreotidtherapie und chirurgische Tumormassenreduktion führten zur raschen Symptomkontrolle. Nach protrahierter Intensivtherapie bei parapneumonischem „acute respiratory distress syndrome“ brachte die Patientin ein gesundes Kind zur Welt. Neuroendokrine Tumoren in der Schwangerschaft sind eine Rarität und seltene Ursache von Hyperkalzämien.
Abstract
A 31-year-old pregnant woman presented with refractory severe hypercalcemia due to an advanced neuroendocrine tumor masquerading as hyperemesis gravidarum. Octreotide therapy and extensive tumor debulking surgery resulted in symptom control. After a prolonged stay in the intensive care unit due to parapneumonic acute respiratory distress syndrome, the patient delivered a healthy child. Neuroendocrine tumors are a rare complication of pregnancy and a seldom cause of refractory hypercalcemia.
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Literatur
Bonnin A, Levitt P (2011) Fetal, maternal, and placental sources of serotonin and new implications for developmental programming of the brain. Neuroscience 197:1–7
Kovacs CS (2011) Calcium and bone metabolism disorders during pregnancy and lactation. Endocrinol Metab Clin North Am 40:795–826
Maffei P, Tamagno G, Nardelli GB et al (2010) Effects of octreotide exposure during pregnancy in acromegaly. Clin Endocrinol (Oxf) 72:668–677
Makras P, Papapoulos SE (2009) Medical treatment of hypercalcaemia. Hormones (Athens) 8:83–95
Morice P, Uzan C, Uzan S (2012) Cancer in pregnancy: a challenging conflict of interest. Lancet 379:495–496
Norman J, Politz D, Politz L (2009) Hyperparathyroidism during pregnancy and the effect of rising calcium on pregnancy loss: a call for earlier intervention. Clin Endocrinol (Oxf) 71:104–109
Pavlidis NA (2002) Coexistence of pregnancy and malignancy. Oncologist 7:279–287
Stewart AF (2005) Clinical practice. Hypercalcemia associated with cancer. N Engl J Med 352:373–379
Touzios JG, Kiely JM, Pitt SC et al (2005) Neuroendocrine hepatic metastases: does aggressive management improve survival? Ann Surg 241:776–783 (Diskussion: 783–775)
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Kühn, M., Blagieva, R., Beha, D. et al. 31-jährige Schwangere mit refraktärer Hyperkalzämie. Internist 53, 1490–1495 (2012). https://doi.org/10.1007/s00108-012-3149-8
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DOI: https://doi.org/10.1007/s00108-012-3149-8