Assessment of Hypercalcemia: Video, Anatomy, Definition & Function | Osmosis

Question

A 67-year-old male comes to his outpatient provider’s office for evaluation of fatigue and diffuse muscle aches. His symptoms started about a year ago and have been progressing over time. He also reports having bowel movement once a week with hard, pellet-like stool formation. Past medical history is significant for insulin-dependent diabetes mellitus type 2 and end-stage renal disease. He underwent a kidney transplant two months ago. His medications include insulin and sirolimus. The patient has a 35-pack-year smoking history but is no longer smoking. In the office, his temperature is 37.6°C (99.7°F), pulse is 68/min, respirations are 14/min and blood pressure is 115/74 mmHg. Laboratory testing reveals the following results:

Laboratory value	Result
Serum chemistry
Serum calcium	11.2 mmol/L
Serum phosphate	2.4 mmol/L
Parathyroid hormone*	560 pg/mL

*Normal range: 10-55 pg/mL

Which of the following is the most likely cause of the patient’s presentation?

Accepted Answer

&#160;Calcium-independent secretion of parathyroid hormone &#160;

Answer

Side effect of sirolimus&#160;

Answer

End-organ resistance to parathyroid hormone

Answer

Secretion of parathyroid-hormone related peptide by a tumor

Answer

Reduced calcitonin secretion by thyroid gland&#160;

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Hypercalcemia

Pathology

Endocrine system