Hypercalcemia in pregnancy and lactation due to parathyroid hormone-related protein production

Lepre, F.; Grill, V.; Danks, Janine A.; Ho, P.; Law, Frieda; Moseley, J. M.; Martın, Thomas

doi:10.1016/0169-6009(90)90376-q

Cited by 12 publications

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“…There is now evidence for its release into the circulation of both goats (Ratcliffe et al, 1991) and rats (Yamamoto et al, 1991) during lactation. It appears to have been responsible for two cases of hypercalcaemia occurring during pregnancy and lactation, one of which was associated with mammary hypertrophy (Lepre et al, 1990;Khosla et al, 1990). The PTHrP measurements in the present patient, however, are inconclusive.…”

Section: Discussionmentioning

confidence: 99%

Post‐pregnancy osteoporosis associated with hypercalcaemia

Reid¹,

Wattie²,

Evans³

et al. 1992

Clinical Endocrinology

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A lactating 31-year-old woman who developed four vertebral fractures 1-2 months after the delivery of her first child is described. She was hypercalcaemic (serum calcium up to 2.99 mmol/l), and urinary excretion of both calcium and hydroxyproline (an index of bone resorption) were markedly elevated. Serum levels of parathyroid hormone and 1,25-dihydroxyvitamin D were suppressed, but parathyroid hormone-related peptide was above normal. There was severe axial osteopenia, as assessed by dual-energy X-ray absorptiometry. The biochemical abnormalities were reversed within 2 weeks of weaning, with the exception of the parathyroid hormone-related peptide concentration, which declined more gradually. This appears to be the first description of the abnormalities in calcium metabolism and bone density from early in the course of post-pregnancy osteoporosis and it indicates that this condition is associated with high levels of osteolysis which return to normal after weaning. This rapid reversal of the metabolic abnormalities accounts for the inconclusive nature of previous descriptions of post-pregnancy osteoporosis, in which investigations were more delayed. It also emphasizes the importance of weaning in the management of women presenting with this condition. A possible aetiological role for parathyroid hormone-related peptide is discussed.

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Section: Discussionmentioning

confidence: 99%