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Maintenance of Serum Calcium by Parathyroid Hormone-Related Peptide During Lactation in a Hypoparathyroid Patient

Division of Endocrinology (C.L.C.), Department of Medicine, University of Alberta, Edmonton AB Canada, and Division of Endocrinology (K.J.M., B.C.), Department of Medicine, University of Calgary, Calgary AB Canada T2N 2T9

Address all correspondence and requests for reprints to: Dr. B. Corenblum, Division of Endocrinology, Department of Medicine, 3330 Hospital Dr. NW, Calgary AB T2N 4N1; E-mail: corenblu{at}acs.ucalgary.ca

We describe the changes in calcium homeostasis seen in a hypoparathyroid woman during the third trimester and with lactation following her second pregnancy. During lactation her need for supplemental calcium and calcitriol abated, and in fact she was transiently hypercalcemic and hypophosphatemic. This change was associated with a rise of serum parathyroid hormone-related peptide (PTHrP) released systemically during lactation. This is the first documentation of the time course of serum PTHrP levels from the late third trimester throughout lactation in a hypoparathyroid woman. In this context PTHrP may have sufficient biological activity to compensate for parathyroid hormone deficiency.

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