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Calcium falsely high due to elevated albumin ?
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Calcium falsely high due to elevated albumin ?

I'm 23, male. My endocrinologist told me I don't have primary hyperparathyroidism but rather I have secondary hyperparathyroidism because my calcium is falsely elevated in the blood reports due to elevated albumin.

What do you think ?

serum ca = 10.48 mg/dl (8.10 - 10.40)   (10/10/12)
pth = 61.20 (15 - 68)                             (10/10/12)
albumin = 4.67 g/dl (3.5 - 5.5)                (10/10/12)
*CORRECTED SERUM CALCIUM* = 9.94 mg/dl

serum ca = 10.58   (8.10 - 10.40)           (8/11/12)
albumin = 4.96 g/dl (3.50- 5)                  (8/11/12)
*CORRECTED SERUM CALCIUM* = 9.81 mg/dl

Other reports

ca = 11 ;  (26/9/12)  
pth = 150 ; ca = 12   (27/9/12) (This could me high due to 2 vitamin d supplements I took with added calcium citrate)
pth = 103.80 (15 - 68); ca = 10.02  (8.10 - 10.40)  (3/10/12)
pth = 51.40 (15 - 68); ca = 10.30   (8.10 - 10.40)   (18/10/12)
pth = 36.20 ; ca = 10.60       (31/10/12)
phosphorus = 3.5 (2.5 - 5.0) (26/9/12)
phosphorus = 5.00   (2.70 - 4.50)  (10/10/12)
phosphorus = 4.89 mg/DL (2.70 - 4.50) (2/11/12)

vitamin d = 3.42 ng/ml ( > 30 ng/ml)  (26/9/12)
vitamin d = 28.80 nmol/L (>-=75 -250)  (16/10/12)
vitamin d = 32.80 nmol (>= 75  -250 )    (31/10/12)

Alkaline phosphate = 353 u/L  (108 - 306) 27/9/12
Alkaline phosphate = 106 u/L  (30 - 120) 20/10/12

creatinine, serum 0.61 mg/DL (0.77 - 1.42)     (2/11/12)
creatinine, serum 0.73 mg/DL (0.77 - 1.42)     (5/11/12)

magnesium  = 1.8 mgm/dl (1.70 - 2.70) (27/9/12)
magnesium = 2.00 mg/DL (1.80 - 2.60) (16/10/12)
magnesium = 1.70 mg/DL (1.80 - 2.60)    (30/10/12)

REFERENCES
http://www.livestrong.com/article/483583-high-calcium-albumin/
http://www.globalrph.com/calcium.cgi
97953_tn?1193367871
These calcium levels are consistently high, accompanied by high or high normal PTH levels.  Your phosphorus has been high or normal, which is not typical with primary hyperparathyroidism.  The vitamin D level looks normal.  Alkaline phosphatase levels have been high or normal.  This is suspicious for primary hyperparathyroidism but as a young adult, calcium levels can normally run in the mid 10 range.  Therefore a second opinion from an endocrinologist may be warranted.
2 Comments
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Avatar_m_tn
New report shows normal pth and a normal calcium level.

Pth = 38.8 (15 - 68) , ca =  9.8 (8.8 - 10.6); ionized ca = 1.21 (1.16 - 1.32) (19/11/12)
albumin = 5.04 g/dl (3.5 - 5)   (19/11/12)
phosphorus = 5.07 (2.7 - 4.50)  (19/11/12)

Ca = 9.99 (8.10 - 10.40)      (20/11/12)
Ca = 10.30 (8.10 - 10.40)    (22/11/12)

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