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Which laboratory finding is characteristic for diagnosing Paget's disease?

  1. Elevated calcium levels

  2. Elevated alkaline phosphatase with normal calcium and phosphorus

  3. Normal alkaline phosphatase with elevated phosphorus

  4. Decreased bone density

The correct answer is: Elevated alkaline phosphatase with normal calcium and phosphorus

Elevated alkaline phosphatase levels with normal calcium and phosphorus are characteristic laboratory findings for diagnosing Paget's disease. This condition is primarily a bone disorder marked by the abnormal and excessive remodeling of bone tissue. The increase in alkaline phosphatase is due to heightened osteoblastic activity as the bone undergoes excessive formation and resorption processes. However, unlike other conditions that can lead to elevated alkaline phosphatase, such as hyperparathyroidism or vitamin D deficiency, the levels of calcium and phosphorus typically remain within the normal range in Paget’s disease. This distinction is crucial for the accurate diagnosis of the disease. In comparison, elevated calcium levels are not typical in Paget's disease and may indicate other conditions involving bone metabolism. Normal alkaline phosphatase with elevated phosphorus does not align with the metabolic profile seen in this disease. Decreased bone density can be a feature of various bone disorders but is not a defining characteristic of Paget's disease, which often displays a mixed pattern of increased and decreased density due to the disorder's complex nature.