PMC5089919_01
A. Blood calcium and phosphorus levels during and after hospitalization. Calcium target range for hypoparathyroidism, 7.6-8.2 mg/dL. Phosphorus normal range for 15 year-old boys: 3-6 mg/dL. Arrow denotes day of pamidronate infusion. 1B. Blood alkaline phosphatase levels. Normal range for 15-year old boys: 100-390 IU/L.
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F1
Five weeks after the fracture, he presented to an emergency department and was found to be hypertensive with a blood pressure of 140/65 and markedly hypercalcemic with a serum calcium of 13.5 mg/dL and phosphate of 3.9 mg/dL (Fig 1A). Serum alkaline phosphate level was 132 U/L, in the low end of the normal range for age (Fig. 1B). The patient was discharged on day 4 with continued outpatient monitoring (Fig 1A). With increasing mobilization after discharge, his alkaline phosphatase level rose steadily, returning to levels consistent with a growing adolescent boy (Fig 1B).