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What Causes Intense Pain On Right Side Of Abdomen?

Posted on Mon, 30 Mar 2015

Question: My 29 year old daughter has been having intense pain on the right side of her abdomen for several months (under rib cage). Also, discovered she has calcium build up in her kidneys. Also, discovered that she has calcium build up in her right hip accompanied by lots of pain. doctors can't figure it out. Now, today, she was told that her blood work shows high calcium and high protein levels. They want to run more tests. What might they be looking for at this point? What could be wrong? She thinks bone marrow cancer according to one search. What do you think?

Answered by Dr. Ajish TP (1 hour later)

Brief Answer:
It could be Hyperparathyroidism

Detailed Answer:
Hi XXXXXX,

Welcome to HCM. I have gone through the question and understand your concerns.

Don't worry. First let us evaluate for the cause of hypercalcaemia.

This could be due to two categories
1. Due to increased parathyroid hormone in blood
2. Other causes - which are rare like sarcoidosis, very rarely tumours

The investigations that we do are fasting calcium, phosphorus, albumin, serum parathyroid hormone and urine calcium creatinine ratio. If parathyroid hormone is high, it is due to Hyperparathyroidism ( common cause for high calcium). If it is low then only we need to look for other causes.

Hope I have answered your questions. If you have any further queries I will be happy to help you.

Regards,

Dr Ajish TP [MD,DM]
Consultant Endocrinologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajish TP (3 minutes later)

Would this also account for high protein levels in blood and the body pain (right side, upper abdomen as well as hip pain)?

Thanks VERY much
XXXXXXX

Answered by Dr. Ajish TP (8 hours later)

Brief Answer:
Body pain can be due to this

Detailed Answer:
Hi XXXXXX,

Welcome back.

The generalised body pain is due to high calcium. This is because of the bone pain as calcium is getting extracted from bone.

High protein is not related to that. Please check her globulin level. If it is high, do a serum electrophoresis to rule out myeloma- as it is associated with high calcium.

Regards
Dr Ajish TP

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajish TP (6 hours later)

I think my final questions:

1 - could myeloma be the cause of the calcium building up in her kidneys?

2 - What is the prognosis for myeloma? (I know it probably depends, but looking for a rough idea of how good and bad this good go)

Very grateful!
XXXXXXX

Answered by Dr. Ajish TP (3 hours later)

Brief Answer:
Let us first confirm the disease

Detailed Answer:
Hi XXXXXX,

Welcome back.

Myeloma is not a common disease at this age group. So let us make a diagnosis first before pressing the panic button.

As you know prognosis of myeloma depends on the stage of disease. Median survival in elderly is around 5 years, can be better in young and with early disease

Regards
Dr Ajish TP

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar