CASE 2 - PowerPoint PPT Presentation

case 2 n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
CASE 2 PowerPoint Presentation
play fullscreen
1 / 12
CASE 2
237 Views
Download Presentation
ranae
Download Presentation

CASE 2

- - - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

  1. CASE 2 • 49 yo man • HIV+ since 1993 • CD4 Nadir 120/7% • Smoker of 45 pack years

  2. CASE 2 Antiviral History

  3. CASE 2 2012 • Depression x yrs • Fatigue x yrs • Arthralgia/Bone pain

  4. CASE 2

  5. CASE 2 • No family history of endocrine abnormalities • No obvious cancer • No ingestion of meds known to cause high calcium • No calcium supplements, vitamins, herbal remedies, OTC’s or calcium carbonate containing products

  6. CASE 2 June 2012 • Of note, drinks 4L of milk daily!!!! • On Ranitidine for GERD • TOLD TO STOP MILK

  7. CASE 2

  8. CASE 2 • Felt much less tired with decreased arthralgia/bone pain when milk consumption eliminated

  9. CASE 2

  10. CASE 2 Further Workup • Serum/urine immunelectrophoresis • normal • CT Chest/Abdo • Normal

  11. CASE 2 Further Workup • U/S Thyroid • Small nodule • No change in size with 3mos f/u • 24 hr urine for calcium • Elevated urinary calcium 8.6 mmole/l (1.2-6.2)

  12. CASE 2 Diagnosis • ?mild primary hyperparathyroidism exacerbated by excessive milk consumption