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Gordon J. Strewler, MD, Discussant

JAMA. 2005;293:1772-1779.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

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.

At the time of her visit, she reported a history of constipation since childhood with no recent . . . [Full Text of this Article]

MS Q: HER VIEW

AT THE CROSSROADS: QUESTIONS FOR DR STREWLER

Epidemiology and Pathophysiology

Evaluation

End-Organ Effects

Natural History and Pathogenesis

Medical Treatment Options

Surgical Treatment Options

Clinical Treatment Guidelines

RECOMMENDATIONS FOR MS Q

QUESTIONS AND COMMENT

AUTHOR INFORMATION

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.

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