A 38 year old black female presents with a 1-year history of
fatigue, malaise, mild dyspnea and weight loss. Key laboratory data: BUN 48, Cr
4.4 (was 3.7 mg/dL two months ago), Alb 3.9, Ca 11.6, PO4 5.2, Mg 2.5, ALT 104, AST
88, Alk phos 554, Bili 0.9, ESR 136; Urine: Ca 17.4, Cr 47.7, Protein 95; U/A: 2+
protein, 2+ blood, 2+ leuk est; USed: 18-22 WBC, 25-30 RBC, 3+ Ca oxalate
crystals; Ultrasound: Rt kidney 10.4 cm with multiple calculi, Lt kidney 10.5
cm with 3 calcifications in the region of the pyramids; no hydronephrosis; iPTH
2.8 pg/ml (NL10-65), 25-vit D 11.8 ng/mL (NL 9-43) , 1,25-vit D, 109.4 pg/mL (NL
15-60); Chest CT: Increased diffuse
lung parenchymal density, enlarged
lymph nodes in axillary, mediastinal and hilar regions.
What’s the diagnosis?
