In a patient’s medical report, the following laboratory results are observed: serum calcium level of 8 mg/dL, serum phosphate (P04) level of 3.2 mg/dL, and an alkaline phosphatase level of 500 units/L. Based on these findings, which of the following medical conditions is the most likely diagnosis?
A. Osteomalacia
B. Hyperparathyroidism
C. Osteoporosis
D. Paget’s disease of the bone
E. Hyperthyroidism
Answer: D
The patient’s laboratory reports show:
Serum calcium level of 8 mg/dL, which is within the normal range (typically around 8.5-10.4 mg/dL).
Serum phosphate (P04) level of 3.2 mg/dL, which is also within the normal range.
Alkaline phosphatase level of 500 units/L, which is elevated.
The combination of normal serum calcium and phosphate levels with an elevated alkaline phosphatase level is indicative of bone turnover or increased bone activity.
The most likely diagnosis in this case is D. Paget’s disease of the bone. Paget’s disease is characterized by increased and disorganized bone remodeling, leading to elevated alkaline phosphatase levels. The serum calcium and phosphate levels are typically within the normal range in Paget’s disease.
The other options are less likely based on the laboratory values provided:
A. Osteomalacia: Osteomalacia is characterized by low serum calcium and phosphate levels, along with bone softening due to vitamin D deficiency.
B. Hyperparathyroidism: Hyperparathyroidism usually leads to hypercalcemia, not normal calcium levels.
C. Osteoporosis: Osteoporosis does not typically lead to elevated alkaline phosphatase levels.
E. Hyperthyroidism: Hyperthyroidism can affect calcium metabolism, but it typically doesn’t cause elevated alkaline phosphatase levels on its own.