Document Detail


Decreased calcitriol requirement during pregnancy and lactation with a window of increased requirement immediately post partum.
MedLine Citation:
PMID:  20061285     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To describe the changes in calcium and calcitriol requirements during pregnancy and lactation in a patient with hypoparathyroidism due to autosomal dominant hypocalcemia. METHODS: We summarize the clinical presentation and treatment of the patient and review the pertinent literature. RESULTS: Calcitriol requirements disappeared during pregnancy in a 34-year-old woman with autosomal dominant hypoparathyroidism secondary to an activating mutation in the calcium-sensing receptor gene. Within hours after delivery, her serum calcium concentration dropped to 4.7 mg/dL (albumin, 3.2 g/dL), and she required intravenous calcium and reinstitution of calcitriol. When lactation began a few days later, her calcitriol requirement again disappeared. As has occasionally been described in the literature, this patient with hypoparathyroidism required no calcitriol during late pregnancy and lactation to maintain a normal serum calcium level. CONCLUSIONS: To our knowledge, this is the first reported case documenting a period of time between pregnancy and lactation when calcitriol requirements reappeared, likely due to a parathyroid hormone-related protein "window" between delivery, when placental production of parathyroid hormone-related protein stops, and lactation, when mammary gland production begins.
Authors:
Laura L Sweeney; Alan O Malabanan; Harold Rosen
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  16     ISSN:  1934-2403     ISO Abbreviation:  Endocr Pract     Publication Date:    2010 May-Jun
Date Detail:
Created Date:  2010-06-16     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  459-62     Citation Subset:  IM    
Affiliation:
Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
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MeSH Terms
Descriptor/Qualifier:
Calcitriol / therapeutic use*
Female
Humans
Hypoparathyroidism / drug therapy*
Lactation / physiology*
Postpartum Period*
Pregnancy
Chemical
Reg. No./Substance:
32222-06-3/Calcitriol
Comments/Corrections
Comment In:
Endocr Pract. 2010 May-Jun;16(3):522-3   [PMID:  20551009 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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