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Previous Volume 331:1456-1458 November 24, 1994 Number 21 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: In the Clinical Problem-Solving exercise on hypercalcemia (July 7 issue),¹ I disagree with Dr. Kreisberg's comment, made more than once, that the diagnosis of primary hyperparathyroidism can be ruled out at an early stage. I submit that this is not the case at all. It is important in any differential diagnosis to bear in mind at the outset that common disorders occur commonly, and the initial diagnostic approach should be based on this principle. The clinical history recounted in the first paragraph is extremely suggestive of primary hyperparathyroidism; in contrast, steroid-responsive vitamin D-mediated hypercalcemia is extremely uncommon.

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References

This article has been cited by other articles:

• Kassirer, J. P. (1995). Teaching Problem-Solving -- How Are We Doing?. NEJM 332: 1507-1509 [Full Text]