Dear Ian,
Noting her age, one wonders whether her creatinine clearance (or other GFR
estimate), serum 25-OH-vit-D, bone x-ray appearances, (& if she has had it -
bone mineral density), may shed any light on the paradoxical results?
Best wishes,
Les
> From: Mohammad Al-Jubouri <[log in to unmask]>
> Reply-To: Mohammad Al-Jubouri <[log in to unmask]>
> Date: Tue, 11 Nov 2003 09:32:14 +0000
> To: [log in to unmask]
> Subject: Re: Hypercalcaemia case
>
> 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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they are responsible for all message content.
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