Answer to the last #DiagnosticDilemma
A 38-Year-Old Man With Back and Side Pain

Final Dx: PRIMARY HYPERPARATHYROIDISM

Nephrocalcinosis most commonly occurs due to primary hyperparathyroidism, in which the parathyroid glands secrete more parathyroid hormone (PTH) than what is needed to maintain a normal serum calcium level.

The most common cause of primary hyperparathyroidism is a parathyroid adenoma, and other causes include parathyroid carcinoma and sporadic parathyroid hyperplasia.

In addition to signs of renal dysfunction, patients may exhibit signs of hypercalcemia, such as constipation, bone pain (due to osteoclasts being indirectly stimulated by PTH to resorb calcium), kidney stones, depression, and seizures. Treatment is via surgically removing the adenoma or parathyroid glands that are responsible.

Source: https://pxmd.co/M0pwu
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