A 62-year-old woman presents with fatigue, constipation, and mild confusion. Serum calcium is 11.8 mg/dL (normal 8.5-10.5), phosphate is 2.1 mg/dL (normal 2.5-4.5), and PTH is 145 pg/mL (normal 15-65). Imaging reveals a 1.2 cm nodule in the inferior pole of the left thyroid lobe. Which of the following is the most likely diagnosis?
- A)Tertiary hyperparathyroidism
- B)Secondary hyperparathyroidism from chronic kidney disease
- C)Sarcoidosis with elevated 1,25-dihydroxyvitamin D
- D)Primary hyperparathyroidismGABARITO
- E)Thyroid carcinoma with PTHrP secretion
Explicação
Primary hyperparathyroidism is confirmed by elevated serum calcium with elevated PTH and low phosphate. The parathyroid adenoma in the inferior pole of the left lobe is the source. This is the most common cause of hypercalcemia in outpatients. Ver explicação completa e trilha adaptativa →