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Clinical Crossroads
Clinician's Corner
April 13, 2005

A 64-Year-Old Woman With Primary Hyperparathyroidism

Author Affiliations

Clinical Crossroads Section Editor: Margaret A. Winker, MD, Deputy Editor.


Author Affiliation: Dr Strewler is Professor and Vice-Chairman of Medicine, Beth Israel-Deaconess Medical Center, and Master, Walter Bradford Cannon Society, Harvard Medical School, Boston, Mass.

JAMA. 2005;293(14):1772-1779. doi:10.1001/jama.293.14.1772

DR BURNS: Ms Q is a 64-year-old woman with a history of mild hypercalcemia and hyperparathyroidism. She has managed care insurance.

Ms Q states that on a routine blood test 7 years ago she was noted to have a calcium level of 10.1 mg/dL (2.5 mmol/L). She has subsequently had her calcium checked on a biannual basis and it has ranged from 10.4 to 11.3 mg/dL (2.6-2.8 mmol/L). Ms Q was referred to an endocrinologist in December 2002 after her calcium was higher than 11 mg/dL (2.7 mmol/L) on 3 occasions. Her laboratory studies just prior to her visit revealed a calcium level of 11.1 mg/dL (2.8 mmol/L), a parathyroid hormone (PTH) level of 102 pg/mL, and a phosphate level of 3.4 mg/dL.