A patient reports bone pain, kidney stones, abdominal pain, and depressed mood. Which endocrine disorder best explains this constellation?

• A. Hyperparathyroidism
• B. Hypoparathyroidism
• C. Pheochromocytoma
• D. Cushing syndrome

Answer: (A)

Elevated calcium levels from overactive parathyroid glands explain this set of symptoms. Parathyroid hormone raises blood calcium by pulling calcium from bone, increasing kidney calcium reabsorption, and promoting intestinal calcium absorption via active vitamin D. The result is hypercalcemia, whose classic manifestations are bone pain from increased bone turnover, kidney stones from calcium in the urine, abdominal discomfort (groans), and neuropsychiatric symptoms such as depressed mood. This pattern is often summarized as bones, stones, groans, and moans. Other endocrine disorders don’t fit this picture: hypoparathyroidism causes low calcium with tingling or cramps; pheochromocytoma causes episodic hypertension and adrenergic symptoms; Cushing syndrome involves weight gain, glucose intolerance, and skin changes rather than a hypercalcemic symptom cluster.