A 34-year-old woman (gravida 3, para 2) at 35 weeks’ gestation

A 34-year-old woman (gravida 3, para 2) at 35 weeks’ gestation complains of sharp, excruciating pain in the right flank radiating into her groin. No chills or fever have been noted. The pain resolved shortly after the patient was seen. Urinary analysis reveals numerous red blood cells (RBCs), some WBCs, and no bacteria. WBC and hematocrit are normal.

• Hyperparathyroidism during pregnancy is a rare disease, usually caused by an adenoma or hyperplasia of the parathyroids.
• However, the presence of renal stones in young women should make one think of this disease.
• Other tests, such as urine cultures and serum calcium and phosphorus, should also be done.
• The urine can be strained for other stones