31-year-old woman with nausea and increased thirst

Test Results

Results of appropriate studies return and show the following:

Serum:

Test (units) Result
Protein electrophoresis Normal
Parathyroid hormone (PTH) 254 pg/mL, 26.9 pmol/L (normal 15-65 pg/mL, 1.6-6.9 pmol/L)
Total vitamin D 22.8 ng/mL, 57 nmol/L (normal 20-50 ng/mL, 50-125 nmol/L)
Angiotensin converting enzyme (ACE) 38 U/L, 633 nkat/L (normal <40 U/L, <670 nkat/L)

Urine:

Test (units) Result
24-hour urine calcium 11 mmol/24 h (normal 2.5-7.5 mmol/24 h)
Urine calcium excretion ratio 0.09
Protein electrophoresis Normal

Imaging:

Test (units) Result
Ultrasonography of the neck Nodule in right lower pole of thyroid
Chest x-ray Normal