Diagnostic Dilemma


A 16 years old boy presented in 2010 with right sided abdominal pain for 15 days. There was no jaundice. He was diagnosed to have hypoparathyroidism in 2003 and was on Rocaltrol {0.75 µg, day} and calcium {1500 mg, day} for the same. His ultrasound in 2004 had shown cholelithiasis but he was asymptomatic till the past 15 days. On examination, weight was 39 kg, and systemic examination was normal except for right upper quadrant tenderness. His liver function tests were normal and ultrasound of abdomen showed cholelithiasis. Serum calcium was 7.4 mg, dl and alkaline phosphatase was 304 IU, L. MRCP showed multiple gall bladder calculi with 2 small calculi in common bile duct suggestive of choledocholithiasis. Child underwent cholecystectomy with choledocholithotomy and stones were extracted. Stone analysis showed presence of calcium and bile pigments cholesterol was absent.

What is the cause of gall stones when serum calcium is still low_?
Answer Discussion :
anita iroko
9 years ago
Amol Naik
rocalcitrol ingestion
9 years ago

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