Monday, October 03, 2011

An Interesting Hypercalcemia Case

I thought I'd share this case I saw not too long ago. The patient, Mr. P, was a 52 year old man who was found incidentally to be hypercalcemic. His serum calcium was 10.9 mg/dL and on repeat 11.2 mg/dL (his albumin was normal, in case you medstudents out there were correctly asking that question).
While the workup of hypercalcemia should include a parathyroid hormone level early on as this may obliviate many other tests if this was inappropriately high (recall that one does not need to have a high PTH to have hyperparathyroidism- a common mistake that I encounter), his PTH was appropriately on the lower end.
So, working along the lines of 'non-PTH mediated hypercalcemia', what is your differential diagnosis, and plan?
(and if you're friends with me on FB and already saw my earlier posting, don't spoil the surprise!)