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Hypercalcemia in children and adolescents.
[familial hypocalciuric hypercalcemia]
In
this
review
,
we
define
hypercalcemia
levels
,
common
causes
for
hypercalcemia
in
children
,
and
treatment
in
order
to
aid
the
practicing
pediatrician
.
One
rare
cause
of
hypercalcemia
in
the
child
is
familial
hypocalciuric
hypercalcemia
(
also
termed
familial
benign
hypercalcemia
)
.
Mutations
that
inactivate
the
Ca-sensing
receptor
gene
FHH
have
been
described
as
an
autosomal
dominant
disorder
,
but
recently
milder
mutations
in
the
CASR
have
been
shown
to
cause
hypercalcemia
when
homozygous
.
Normal
serum
levels
of
calcium
are
maintained
through
the
interplay
of
parathyroid
,
renal
,
and
skeletal
factors
.
In
this
review
,
we
have
distinguished
the
neonate
and
infant
from
the
older
child
and
adolescent
because
the
causes
and
clinical
features
of
hypercalcemia
can
differ
in
these
two
age
groups
.
However
,
the
initial
approach
to
the
medical
treatment
of
severe
or
symptomatic
hypercalcemia
is
to
increase
the
urinary
excretion
of
calcium
in
both
groups
.
In
most
cases
,
hypercalcemia
is
due
to
osteoclastic
bone
resorption
,
and
agents
that
inhibit
or
destroy
osteoclasts
are
,
therefore
,
effective
treatments
.
Parathyroid
surgery
,
the
conventional
treatment
for
adults
with
symptomatic
primary
hyperparathyroidism
,
is
recommended
for
all
children
with
primary
hyperparathyroidism
.
Diseases
Validation
Diseases presenting
"primary hyperparathyroidism"
symptom
cystinuria
familial hypocalciuric hypercalcemia
primary hyperoxaluria type 1
This symptom has already been validated