Tuesday, 18 June 2013

A Young Man With Hypercalcaemia

A 32 year old man is referred by his GP with hypercalcaemia. Corrected serum calcium is 2.75 mmol/l (11 mg/dl). Serum PTH is raised at 105 pg/ml (normally up to~70). Serum phosphate is normal. Serum 25(OH)D levels are at the upper limit of normal. Chest Xray is normal, as is a myeloma screen. Alkaline phosphatase is not raised. Renal function is normal, with an egfr of >90 ml/min.

What's the likely diagnosis?

3 comments:

  1. ....since pt.is aymptomatic...& has been referred with complaints of Hypercalcaemia with the malignancy part ruled out alongwith with the Renal cause with a normal S.Alk phosphatase as suggested ruling out any Excessive Bone turnover& with a normal S.25(OH)_2D,ruling out intoxication & above all with a normal Phospate levelI am more inclined to think in terms of Parathyroid-related, FHH : Familial Hypercalciuric HyperCalcemia....
    Tnx...regards
    Shonkus

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  2. Well done Shonkus!! Familial hypocalciuric hypercalcaemia it is.

    Full marks!

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