Maternal primary hyperparathyroidism should be excluded when infants present with hypocalcaemic convulsions or tetany

Primary hyperparathyroidism is a relatively common condition, being the third most common endocrine disorder after diabetes and thyroid disease. It is most often seen in patients in their 50s and 60s,1 but it can occur in juveniles, although rarely, when the diagnosis may be delayed.2 In women of childbearing age, there is an estimated incidence of 8 per 100 000 population per year.3 Pregnant patients with primary hyperparathyroidism may be asymptomatic or have subtle symptoms such as fatigue, thirst, constipation, or transient depression. These are common complaints in the general population and pregnant patients may attribute them to pregnancy. We describe two patients, seen within one year, in whom primary hyperparathyroidism was diagnosed after convulsions in their infants. Large parathyroid adenomas were localised in both patients by using technetium sestamibi scanning, and these were surgically removed.4