title: Fasting calcium excretion and parathyroid hormone together distinguish familial hypocalciuric hypercalcaemia from primary hyperparathyroidism.
abstract: 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.
authors.affiliation: Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia.
authors.forename: B G
authors.initials: BG
authors.lastname: Stuckey
authors.forename: G N
authors.initials: GN
authors.lastname: Kent
authors.forename: D H
authors.initials: DH
authors.lastname: Gutteridge
authors.forename: P T
authors.initials: PT
authors.lastname: Pullan
authors.forename: R I
authors.initials: RI
authors.lastname: Price
authors.forename: C
authors.initials: C
authors.lastname: Bhagat
mesh_terms: D000328:Adult; D002118:Calcium / Q000652:urine*; D003937:Diagnosis, Differential; D005215:Fasting; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism; D006961:Hyperparathyroidism / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium