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Genetic defects associated with familial and sporadic hyperparathyroidism.
[familial hypocalciuric hypercalcemia]
Primary
hyperparathyroidism
(
PHPT
)
occurs
sporadically
,
but
occasionally
it
may
be
a
feature
of
a
familial
condition
,
such
as
multiple
endocrine
neoplasia
type
1
(
MEN
1
)
,
MEN
2
A
,
or
the
HPT-jaw
tumor
syndrome
(
HPT-JT
)
,
and
familial
hypocalciuric
hypercalcemia
/
neonatal
severe
hyperparathyroidism
(
FHH
/
NSHPT
)
.
PHPT
may
also
occur
as
familial
isolated
hyperparathyroidism
(
FIHP
)
,
and
has
been
observed
as
a
consequence
of
mutations
in
the
CDKN
1
B
gene
(
MEN
4
)
.
Tumorigenesis
in
these
conditions
may
be
the
result
of
protooncogene
activation
(
e
.
g
.
RET
in
MEN
2
)
or
two
-hit
losses
of
a
tumor
suppressor
(
e
.
g
.
MEN
1
,
HPT-JT
)
.
In
patients
with
MEN
1
,
HPT-JT
or
FHH
/
NSHPT
,
the
hyperparathyroidism
manifests
at
a
younger
age
and
affects
both
sexes
equally
.
In
MEN
1
,
mutations
of
the
MEN
1
gene
also
cause
enteropancreatic
and
anterior
pituitary
tumors
.
In
MEN
2
,
activating
mutations
in
the
RET
protooncogene
also
cause
medullary
thyroid
carcinoma
and
pheochromocytoma
.
In
HPT-JT
,
mutations
of
CDC
73
/
HRPT
2
are
associated
with
parathyroid
carcinoma
,
but
tumors
of
the
kidneys
and
uterus
are
additional
features
.
In
some
FIHP
families
,
a
CASR
mutation
may
be
identified
.
In
parathyroid
carcinoma
,
even
if
sporadic
,
molecular
diagnostics
for
CDC
73
/
HRPT
2
should
be
considered
,
as
it
should
be
for
younger
patients
.
Further
exploration
of
these
hereditary
syndromes
may
shed
light
on
the
molecular
mechanisms
giving
rise
to
nonhereditary
PHPT
.
Diseases
Validation
Diseases presenting
"parathyroid carcinoma"
symptom
familial hypocalciuric hypercalcemia
This symptom has already been validated