A 56-year-old woman presents with recurrent nephrolithiasis and progressive diffuse bone pain. Vital signs: BP 138/82 mmHg, HR 88/min, RR 14/min, temperature 37.2°C. Laboratory studies reveal serum calcium 11.8 mg/dL, phosphate 2.1 mg/dL (low), intact PTH 285 pg/mL (elevated), and 24-hour urine calcium 380 mg/day (high). Renal ultrasound confirms bilateral calcium oxalate stones. She denies recent hyperthyroidism symptoms. Which of the following is the most likely diagnosis?
- A)Pseudohypoparathyroidism
- B)Hypoparathyroidism
- C)Primary hyperparathyroidismGABARITO
- D)Calcitonin excess
- E)Vitamin D deficiency
Explicação
Primary hyperparathyroidism is most often caused by a parathyroid adenoma and leads to elevated PTH, hypercalcemia, and hypophosphatemia. Ver explicação completa e trilha adaptativa →