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Clinical and biochemical outcomes of cinacalcet treatment of familial hypocalciuric hypercalcemia: a case series.
[familial hypocalciuric hypercalcemia]
Familial
hypocalciuric
hypercalcemia
is
a
rare
benign
autosomal-dominant
genetic
disease
with
high
penetrance
.
In
most
cases
,
patients
with
familial
hypocalciuric
hypercalcemia
experience
unspecific
physical
discomfort
or
asymptomatic
disease
.
These
patients
are
typically
characterized
by
mild
to
moderately
increased
blood
ionized
calcium
and
a
normal
to
slightly
elevated
serum
parathyroid
hormone
.
Four
female
patients
with
familial
hypocalciuric
hypercalcemia
with
inactivating
mutations
in
the
CaSR
gene
were
included
in
the
treatment
study
.
Three
patients
were
related
:
two
were
siblings
and
one
was
the
daughter
of
one
of
these
.
The
ages
of
the
related
patients
were
51
years
,
57
years
and
35
years
.
All
three
patients
were
carriers
of
the
same
mutation
.
The
fourth
patient
,
unrelated
to
the
others
,
was
53
years
old
,
and
a
carrier
of
a
novel
and
previously
unknown
mutation
leading
to
familial
hypocalciuric
hypercalcemia
.
All
four
patients
were
Caucasians
of
Danish
nationality
.
Biochemically
,
all
patients
had
elevated
blood
ionized
calcium
,
serum
parathyroid
hormone
,
serum
magnesium
and
total
serum
calcium
,
except
one
,
whose
serum
parathyroid
hormone
was
within
the
normal
range
prior
to
treatment
.
All
patients
were
treated
with
cinacalcet
in
a
dosage
of
30
mg
to
60
mg
per
day
.
Three
months
after
the
initiation
of
cinacalcet
treatment
,
all
our
patients
experiencing
clinical
signs
of
hypercalcemia
had
improved
in
self
-
reported
well-being
and
in
biochemical
parameters
.
None
of
our
patients
suffered
adverse
events
to
cinacalcet
treatment
.
Biochemical
markers
of
calcium
homeostasis
were
improved
and
remained
stable
during
the
observation
period
of
12
months
(
two
patients
)
,
24
and
36
months
,
in
both
the
symptomatic
and
the
asymptomatic
patients
.
Diseases
Validation
Diseases presenting
"unspecific physical discomfort"
symptom
familial hypocalciuric hypercalcemia
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