Case Presentation: A 54-year-old man with a history of alcoholic cirrhosis presented to the emergency department for evaluation of a new facial rash and was found to be hypercalcemic to 15.6 mg/dL. A subsequent ionized calcium and cystatin C were also found to be elevated at 1.90 mMol/L and 2.55 mg/L (eGFR 23), respectively. His [...]

Case Presentation: A 65 year old male with hypertension, type II diabetes, heart failure with recovered ejection fraction and emphysema with 30 pack year smoking history started to experience 15 pound weight loss and anemia 18 months ago. Initial presentation to PCP revealed elevated ALP 292U/L and Hemoglobin 12.6g/dL. Cancer screening with CT chest showed [...]

Case Presentation: A 40-year-old man with a history of severe tophaceous gout, not currently on treatment, was directly admitted to the hospital after routine labs showed hypercalcemia (14.1mg/dL) and an elevated creatinine (4.2mg/dL). Vital signs were stable. Exam was significant for large nodules and tophi across most joints, with innumerable subcutaneous nodules embedded in the [...]