Disorders of calcium metabolism

©IOS/S Nussey

Box 5.2 - Control of serum calcium

Box 3.21 - Embryology of parathyroid glands

Normal parathyroid

Parathyroid adenoma

Hypercalcemia - Investigations

• Establish hypercalcemia is real; check renal function

• Measure serum PTH, 25-OH-vitamin D, PTHrp, T4, ACE as appropriate

• Radiological investigations– Basic - e.g. hands, KUB, CXR– Localization

Radiology of hyperparathyroidism

Sarcoidosis

Parathyroid - 99mTechnetium/201Thallium subtraction scan

Clinical Case 5.4 99mTechnetium bone scan

99mTc-sestaMIBI scan

(MIBI = methoxyisobutylisonitrile)

Box 5.28: Vitamin D deficiency

Box 5.28: Vitamin D deficiency

Clinical Case 5.7

Clinical Case 5.6