The Case | A pregnant female with refractory hypocalcemia

A 25-year-old gravida 1 parity 0 female patient at 20 weeks of gestation was found to have asymptomatic hypocalcemia during her prenatal evaluation. Despite calcium and calcitriol supplementation for 4 months, her hypocalcemia persisted. The patient had no medical or surgical history, and there had been no exposure to other medications except prenatal vitamins. Family history was positive for maternal hyperparathyroidism with a history of kidney stones. The patient denied any symptoms including paresthesia, seizures, muscle twitching, or spasms. Physical examination was normal with negative Trousseau’s and Chvostek’s signs.