Parathyroid hormone in the evaluation of hypercalcemia.

A 54-year-old woman was incidentally noted to have hypercalcemia on routine testing. She feels well and reports no concerns. She underwent total thyroidectomy 15 years earlier for papillary thyroid cancer and is taking levothyroxine suppression therapy without evidence of recurrence. Serum calcium levels before her thyroidectomy were normal. She has well-controlled hypertension and hyperlipidemia. Her other medications include losartan, atorvastatin, and ezetimibe. She has no history of low trauma fractures (occurring from falls at standing height or less) or nephrolithiasis. She has no family history of hypercalcemia. Physical examination demonstrated no palpable thyroid tissue. Her laboratory values are reported in the Table. Table Patient’s Laboratory Test Results