This patient has dual pathology:
1.Primary hyperparathyroidism.
2. Hypocalciuria? cause. ? thiazide-induced, ? or she
could have coexisting Gitelman syndrome, FHH or even
could have the novel homozygous inactivating mutation
of calcium-sensing receptor!!
Best wishes
Mohammad
--- Ian Barlow <[log in to unmask]> wrote: > Dear
colleagues,
> Female patient (85 yr old), with persistent
> hypercalcaemia, (malignancy
> excluded).
> Recent serum adjusted calcium = 3.59 mmol/L, Serum
> PTH 19.0 pmol/L
> (1.6-6.9).
> 24 hr urine calcium <1.0 mmol/24hrs on 2 occasions.
> Fasting urine calcium excretion 13.8 (umol/L GF) -
> (primary hyperparathyroid
> patients usually have CaE of >25).
> Fasting urine calcium clearance = 0.003 (primary
> hyperparathyroid patients
> usually > 0.02).
> Presumably she has primary hyperparathyroidism but
> how does one explain the
> low urine indices (which were all assayed prior to
> any treatment).
> Any comments would be appreciated.
>
> Ian Barlow
> Scunthorpe
> UK
>
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=====
Dr. M A Al-Jubouri
Consultant Chemical Pathologist
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------ACB discussion List Information--------
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community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
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