A 57-Year-Old Woman With an Incidental Laboratory Finding, Part 1

An otherwise healthy 57-year-old woman presents for further evaluation following an incidental laboratory finding on her yearly employment health evaluation. She presents with an unremarkable serum biochemistry panel except for a serum calcium level of 11.3 mg/dL (normal range: 8.5-10.5 mg/dL). The patient's serum phosphorous and albumin levels, as well as her complete blood count, were within normal limits.

Patient history. The patient is otherwise in good health with no specific symptoms to note: no pains, fatigue, nor constipation. She had menopause at age 50 and previously delivered two healthy children. She has never smoked and uses alcohol only occasionally. She is active, regularly playing pickleball and tennis with friends. She works at a printing firm in an executive position, which requires a yearly physical examination and routine blood testing. Although the physical examination was within normal limits, the blood test revealed an elevated calcium level of 11.3 mg/dL, and a subsequently ordered serum parathyroid hormone (PTH) level was 57 pg/dL (normal range: 15-65 pg/dL).

(Answer and Discussion on the next page)