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Avatar universal

Calcium question

I am writing in reference to my son.  He is 25 and last year began to have painful episodes with passing kidney stones.  One stone had to be treated with shockwave lithroscopy.  Scans indicate multiple, bilateral stones.  Since that time, he has had gastric pain, nausea, flank pain, sleeplessness, etc.  I had a parathyroid adenoma a couple of years ago myself, so I was familiar with the problems of high calcium and requested some tests.  They have come back and shown a calcium level of 10.; 10.2 and 10.6.  However, his PTH was 10.  Further tests have shown hypocitraturia (199 mg in 24 hr. urine test); 24 hr. urine volume of .97; PCR .6; and normal calcium level in urine.

One stone was evaluated as 60% calcium oxalate monohydrate and 40% calsium oxalate dihydrate.  He has been bounced around between a gastro doc and internist, looking for gastric causes of his stomach complaints.  Our family doc did a simple urine test in the office and found he had considerable blood in his urine.

Since the stomach trouble started after the stones, I don't really think this is gastric, as it has very similar characteristics of my previous hyperparathyroidism and I think he probably should have his parathyroid checked out.  Any input would be appreciated- he is tired of not knowing what is going on and of being in pain.  Thanks-
6 Responses
97953 tn?1440868992
The parathyroid level appears normal or low, suggesting against primary hyperparathyroidism.  However with your history I would recommend repeating PTH along with calcium.  However, it is not unusual for young adults to run calcium levels in the low 10 range.
Avatar universal
Thanks for the response to my question regarding my 25 year old son.  I've heard it isn't unusual for young adults to have higher calcium.  However, it seems a bit unusual for someone (was a healthy exerciser, etc.) to be producing multiple stones and then there's the very low citraturia.  We are looking for a way to address the cause of the stones and citraturia and didn't know exactly what direction to look.
Would you expect to see so many stones from that level of calcium at that age?

Any other thoughts?

Avatar universal
I had a Calcium level of 10.5 and yes I had hyperparathyroidism - MIP surgery removed 2 benign tumors. I am an older woman but his gastric symptoms sound similar to mine, although I didn't have kidney stones. It took a year to diagnose and I finally diagnosed it myself with the help of Dr Norman's site on line.
Avatar universal
I ran across this website (by doctors) on the parathyroid..perhaps it will help
Avatar universal
That is Dr Norman's site.
Avatar universal
Thanks for the input.  We got a report from his IVP scan on Thursday and they are pretty sure it looks like something called medullary sponge kidney (MSK).  We are on a learning curve to get up to speed on it.  He was seen by a nephrologist that same day; meant to ask him how many of these cases he has seen and treated but we were a bit overwhelmed at the moment.  I don't know how unusual it is.  He has multiple calculi in both kidneys and over the outline of them.

The discouraging thing for him is that the Doc doesn't attribute any of his abdominal/groin pain to this condition since he doesn't seem to be passing a stone presently.  He's had this pain for months now.  He mentioned irritable bowel syndrome, which I consider the trash can diagnosis when docs don't know what else it might be!  I am not convinced the kidney problems aren't causing the pain.

Any info on MSK from anyone would be great.  Thanks
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