Clinical Case 5.1

A 45-year-old woman presented to her primary care physician with general malaise, aches and pains, anorexia and weight loss of more than 3 months duration. Her only other symptoms had been polyuria and polydipsia, which, together with the weight loss, had suggested the diagnosis of DM. Her physician had, therefore, arranged for some biochemical tests to be performed. The fasting serum glucose concentration was normal (4.1 mmol/l, NR <3–6.0 mmol/l) but he was concerned when the laboratory staff phoned the surgery to report that her total serum Ca²⁺ was high at 4.1 mmol/l (NR 2.2–2.6 mmol/l) with an albumin of 38 g/l (NR 38–40 g/l). Her serum urea and electrolyte concentrations were normal as were her routine hematological investigations.