Table 2.

Teaching points

CYP24A1 pathogenic variants are a cause of vitamin D−mediated hypercalcemia, which is exacerbated by pregnancy, particularly following delivery

Maternal and neonatal complications have been described, including renal dysfunction, hypertensive disorders of pregnancy and preeclampsia, preterm delivery, and fetal growth restriction and death

Regulation of vitamin D and calcium intake is key

Treatment options in pregnancy are limited due to safety concerns Calcitonin was used in this case and appears safe and effective

Management of gestational hypercalcemia reduced complications, particularly in the offspring