Confusion and hypercalcemia in an 80-year-old man

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TABLE 1

Our patient’s laboratory values on admission

Substance	Value	Reference range
Ionized calcium, mmol/L	1.72	1.08–1.30
Phosphorus, mg/dL	7.0	2.5–4.5
Parathyroid hormone, pg/mL	11	15–65
Parathyroid-related hormone, pmol/L	0.3	< 2.0
25-Hydroxyvitamin D, ng/mL	365.5	31–80
1,25-Dihydroxyvitamin D, pg/mL	59.5	1 5–60
Vitamin A, μg/dL	48	20–120
Thyroid-stimulating hormone, mlU/L	1.380	0.400–5.500
Serum protein electrophoresis and 24-hour urinary protein electrophoresis with immunofixation	No M protein
Beta-2 microglobulin, mg/mL	6.2	0.3–1.9
Alpha fetoprotein, ng/mL	20.1	< 11
Angiotensin-converting enzyme, mg/L	32	< 40