13year old female presented with 3 weeks h/o pain right knee and right elbow, vomitting and constipation..She had h/o menorrhagia for which gynaec doctor gave ocps 1 month back. o/e pallor + ln - chest no added sounds,no murmurs abdomen soft cns-wnl x-ray were taken which is posted below s.calcium-12.6 s.phosphate-2.4 iPTH<1 rft-30/0.6 serum electrolytes-sodium 137 potassium-4.6 cbc-8500 ure-pus cells 6-8 serum ace- normal serum ferritin-350 ldh-368 ALP-128

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Its a case of hyperparathyroidism.
Thank you everyone for the input.. Final diagnosis came today after BMT and flow cytometry.. It's a case of B cell Acute Lymphoblastic Leukaemia
Wat abt the peripheral smear ???
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One can also plan for ct scan of the gland and vit D level(25 OH vit D) In this probably benign tumor
Parathyroid may not be high in some tumor conditions.. also get renal profile
Yes.. might be PTHrP due to some occult malignancy.. Awaiting result
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Pseudohyperparathyroidism xray shows punched out lesions
Praaneolastic syndrome causing pseudohypoparathyrodism
Pseudohyperparathyroidism
Hyper parathyroidism
Hyperparathyroidism
Very low PTH..
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Hyperparathyroidism
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