10th August 2020

A 56-year-old woman who has general aches and pains in her body comes into the General Practice (GP) today

A 56-year-old woman who has general aches and pains in her body comes into the General Practice (GP) today. She complains that her body pains are getting worse and interfering with her daily life. She has a history of poorly controlled essential hypertension which has led to renal failure- CKD grade 2. She also has depression and anxiety. She does not take any medication and has no allergies. She lives with her husband and 2 sons, and works as an interior design decorator. 

On examination she has MRC (Medical research council) Grade 3 which is limited due to pain. She experiences pain on palpation of her muscles and bony regions across all her limbs. The GP orders blood tests which show the following: Calcium 2.01, Phosphate 0.81, Vitamin D 57, PTH 9.0, ALP 160. What is the most likely diagnosis?

Normal data levels:

Calcium= 2.12-2.65

Phosphate= 0.85-1.45

Vitamin D= 60-105

Parathyroid Hormone PTH= 0.8-8.5

Alkaline Phosphatase ALP= 30-150

For the patient above, please select the SINGLE most likely diagnosis. Select ONE option from the list above.