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October 5, 1970

Hypercalcemia Found by Multiple Test Screening

JAMA. 1970;214(1):149. doi:10.1001/jama.1970.03180010089030

To the Editor.—  Having recently encountered two fine examples of unsuspected hypercalcemia diagnosed with use of an automated multiple analysis system, I feel that a brief report might be in order for those who remain reluctant to utilize such techniques.

Report of Cases.—  The first case was that of a 60-year-old man who was admitted for inguinal herniorrhaphy for a gradually enlarging hernia of two years' duration. The multiple analysis system revealed an elevated serum calcium level as the only abnormality. An intravenous pyelogram revealed an enlarged left kidney. The hypercalcemia reverted to normal after nephrectomy for hypernephroma, apparently a case of pseudo-hyperparathyroidism.1,2The second patient was a 67-year-old woman with intermittent claudication who was admitted for peripheral vascular surgery. The multiple analysis performed on admission revealed an elevated calcium level, a decreased phosphorus level, and an elevated phosphatase level. The patient underwent a successful parathyroidectomy for an adenoma.