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Primary hyperparathyroidism — SCE Rheumatology MCQ

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ModerateMetabolic bone diseasePrimary hyperparathyroidismSCE Rheumatology

A 55-year-old woman has recurrent renal stones, constipation and wrist chondrocalcinosis. Calcium is 2.91 mmol/L, phosphate is low, ALP is mildly raised and PTH is inappropriately high. What is the most likely diagnosis?

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Correct answer: E — Primary hyperparathyroidism

Hypercalcaemia with inappropriately high PTH supports primary hyperparathyroidism. It can be associated with renal stones and CPPD/chondrocalcinosis. Tumour-induced osteomalacia causes hypophosphataemia with low or normal calcium rather than PTH-mediated hypercalcaemia.

Reference: NICE NG132 Hyperparathyroidism; EULAR CPPD recommendations