[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-412428-105":59,"doc-detail-412428-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","an-uncommon-case-of-lactational-hypercalcemia-with-diagnostic-and-therapeutic-challenges","An Uncommon Case of Lactational Hypercalcemia With Diagnostic and Therapeutic Challenges","","A 35-year-old postpartum patient was referred for elevated serum calcium found during routine postpartum laboratory testing. With suppressed parathyroid hormone and persistent vomiting during pregnancy, her work-up excluded malignancy, sarcoidosis, and other common etiologies using bone studies, inflammatory markers, myeloma screening, and advanced imaging. Trials of intravenous fluids, low-dose steroids, and calcium management failed to resolve hypercalcemia. After extensive interdisciplinary evaluation, ectopic PTH/PTHrP secretion was identified. The case emphasizes diagnostic complexity and coordinated care among obstetrics, endocrinology, and maternity services.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/an-uncommon-case-of-lactational-hypercalcemia-with-diagnostic-and-therapeutic-challenges/412428/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/an-uncommon-case-of-lactational-hypercalcemia-with-diagnostic-and-therapeutic-challenges/412428.png","ImageObject",300,407,{"name":92,"@type":93},"Guten tag","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why was parathyroid hormone (PTH) suppression important in this case?","Question",{"text":112,"@type":113},"Suppressed PTH suggested a non-PTH-related cause of hypercalcemia, prompting further investigation for alternative mechanisms such as ectopic PTH/PTHrP secretion.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which conditions were excluded during the diagnostic work-up?",{"text":117,"@type":113},"The evaluation excluded malignancy, sarcoidosis, and other common causes through comprehensive testing including bone profile, myeloma screening, ESR assessment, and imaging (CT/PET) plus respiratory evaluation.",{"name":119,"@type":110,"acceptedAnswer":120},"What treatments were attempted before the final diagnosis?",{"text":121,"@type":113},"Management included intravenous fluids, low-dose steroids, and calcium-related measures; persistent hypercalcemia led to referral to specialized centers.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},412428,1790795041,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},687212321768,"https://ap-avatar.wpscdn.com/avatar/a0010bdbe886d2fe77?x-image-process=image/resize,m_fixed,w_180,h_180&k=1789897067658708522","Review began 11/01/2025  \nReview ended 11/24/2025  \nPublished 12/01/2025  \n© Copyright 2025  \nSathiyaseelan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98247  \nOpen Access Case Report  \nAn Uncommon Case of Lactational Hypercalcemia With Diagnostic and Therapeutic Challenges  \nYaline Sathiyaseelan 1, Ananth Srinivashan 1, Guganesan Vitush 2  \n1. Department of Internal Medicine, St. Mary 's Hospital, Isle of Wight National Health Service (NHS) Trust, Newport, GBR 2. Department of General Surgery, St. Mary 's Hospital, Isle of Wight National Health Service (NHS) Trust, Newport, GBR  \nCorresponding author: Yaline Sathiyaseelan, [yalinepavi@gmail.com](yalinepavi@gmail.com)  \nAbstract  \nA 35-year-old female patient was referred to General Medicine by Obstetrics for high calcium levels identified in routine postpartum lab tests. She had persistent vomiting throughout pregnancy and had been managed with antiemetics without lasting relief. On initial work-up, her parathyroid hormone (PTH) was found to be suppressed, suggesting a non-PTH-related etiology. Comprehensive investigations, including bone profile, erythrocyte sedimentation rate (ESR), myeloma screening, imaging (CT, PET), and respiratory evaluation, excluded malignancy, sarcoidosis, and other common causes. Despite a trial of intravenous (IV) fluids, low-dose steroids, and calcium management, the patient 's condition persisted, necessitating referral to specialized centers. After exhaustive consultations, ectopic PTH secretion was identified as the likely cause of the elevated calcium levels. Given the challenges related to lactation and breastfeeding, the management required coordination between obstetrics, endocrinology, and maternity services to ultimately manage hypercalcemia. This case highlights the diagnostic complexity and the importance of an interdisciplinary approach in managing rare conditions like lactational hypercalcemia and ectopic  \nPTH secretion in the postpartum period.  \nCategories: Obstetrics/Gynecology, Internal Medicine, Endocrinology/Diabetes/Metabolism Keywords: case report, ectopic secretion, lactational hypercalcemia, parathyroid hormone, postpartum hypercalcemia  \nIntroduction  \nPostpartum hypercalcemia is an uncommon but clinically important condition that can present significant diagnostic and management challenges. In most adults, hypercalcemia arises from primary hyperparathyroidism or malignancy, but in the postpartum and lactation period, alternative etiologies such as parathyroid hormone-related peptide (PTHrP) excess, vitamin D metabolism disorders, and genetic defects must also be considered [1,2] .  \nDuring pregnancy and lactation, calcium homeostasis undergoes complex adaptations to meet the increased calcium demands ofthe developing fetus and milk production. These physiologic changes involve elevated circulating levels of 1,25-dihydroxyvitamin D, increased intestinal calcium absorption, and secretion of PTHrP from the mammary glands, which enhances bone resorption to mobilize calcium for breast milk synthesis [1,3] . While these mechanisms are typically well regulated, excessive or dysregulated PTHrP production can lead to pathologic hypercalcemia in the absence of malignancy or parathyroid disease [1,3] .  \nIn addition, recent studies have identified CYP24A 1 gene mutations as an emerging cause of pregnancyand lactation-associated hypercalcemia. These mutations impair the degradation of active vitamin D metabolites, resulting in increased calcium absorption and impaired calcium clearance [2,4] . Recognition of this mechanism has expanded the differential diagnosis of postpartum hypercalcemia beyond traditional endocrine and malignant causes.  \nWe present a rare case of postpartum hypercalcemia in a lacta","cbCaivsvXzO0CL0k","https://ap.wps.com/l/cbCaivsvXzO0CL0k","pdf",351159,"English","# Introduction\n# Case Presentation\n## Investigations\n# Discussion","[{\"question\":\"Why was parathyroid hormone (PTH) suppression important in this case?\",\"answer\":\"Suppressed PTH suggested a non-PTH-related cause of hypercalcemia, prompting further investigation for alternative mechanisms such as ectopic PTH/PTHrP secretion.\"},{\"question\":\"Which conditions were excluded during the diagnostic work-up?\",\"answer\":\"The evaluation excluded malignancy, sarcoidosis, and other common causes through comprehensive testing including bone profile, myeloma screening, ESR assessment, and imaging (CT/PET) plus respiratory evaluation.\"},{\"question\":\"What treatments were attempted before the final diagnosis?\",\"answer\":\"Management included intravenous fluids, low-dose steroids, and calcium-related measures; persistent hypercalcemia led to referral to specialized centers.\"}]","An Uncommon Case of Lactational Hypercalcemia With Diagnostic and Therapeutic Challenges | PDF",1790591505,13]