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FASTING CALCIUM EXCRETION AND PARATHYROID HORMONE TOGETHER DISTINGUISH FAMILIAL HYPOCALCIURIC HYPERCALCAEMIA FROM PRIMARY HYPERPARATHYROIDISM
Author(s) -
STUCKEY B. G. A.,
KENT G. N.,
GUTTERIDGE D. H.,
PULLAN P. T.,
PRICE R. I.,
BHAGAT C.
Publication year - 1987
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1987.tb01182.x
Subject(s) - hypercalcaemia , primary hyperparathyroidism , medicine , endocrinology , parathyroid hormone , asymptomatic , hypercalciuria , renal function , hyperparathyroidism , population , excretion , calcium , environmental health
SUMMARY Routine estimation of plasma calcium has made the finding of asymptomatic hypercalcaemia a frequent occurrence. A high index of suspicion for familial hypocalciuric hypercalcaemia (FHH) will lead to accurate diagnosis and avoidance of unnecessary parathyroid surgery. Four FHH kindreds with 16 hypercalcaemic members were found in an unselected referral population over 3 years. Differentiation from primary hyperparathyroidism (42 patients in the same period) was facilitated by analysis of fasting blood and urine for renal handling of calcium, phosphate and cyclic AMP. We found that a plot of serum PTH against fasting calcium excretion separated all cases of each disorder. The discriminatory power of these two variables was confirmed by multivariate discriminant function analysis. An elevated plasma chloride was found to be common to both diseases and of no value in differentiation.