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CLINICIAN’S CORNER
A 64-Year-Old Woman With Primary Hyperparathyroidism
Gordon J. Strewler, MD, Discussant
JAMA. 2005;293:1772-1779.
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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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