A 68-year-old man with nephrolithiasis history presents with progressive bone pain, constipation, and depression. Vital signs: BP 138/82 mmHg, HR 88/min, RR 16/min, temp 37.2°C. Laboratory studies reveal serum calcium 12.2 mg/dL, phosphate 2.0 mg/dL, PTH 180 pg/mL, and alkaline phosphatase 92 U/L. Urinalysis shows no hematuria. He denies recent immobilization or thiazide use. Which diagnosis best explains these findings?

1. A)Vitamin D intoxication
2. B)Rhabdomyolysis
3. C)Primary hyperparathyroidismGABARITO
4. D)Chronic hypoparathyroidism
5. E)Tumor lysis syndrome