Stopping Short of Certainty

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Abstract
A 68-year-old man was evaluated for a two-year history of hypercalcemia, constipation, generalized weakness, and slowing of intellectual function. He had a 20-year history of recurrent nephrolithiasis. He had been treated for a peptic ulcer at the age of 60 and had had no symptoms of recurrent ulcer disease thereafter. He had also had mild hypertension treated with atenolol and stable renal insufficiency (blood urea nitrogen level, 46 mg per deciliter; serum creatinine level, 3.3 mg per deciliter) since the age of 66. Hypercalcemia was first detected when the patient was 60 years old, when he passed a kidney . . .

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