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Familial hypocalciuric hypercalcemia revealed by chondrocalcinosis.
[familial hypocalciuric hypercalcemia]
Calcium
pyrophosphate
dihydrate
crystal
deposition
disease
(
CPPD-CDD
)
has
been
associated
to
hypercalcemia
.
Familial
hypocalciuric
hypercalcemia
(
FHH
)
is
a
rare
but
important
consideration
in
the
differential
diagnosis
of
hypercalcemia
.
This
autosomal
dominantly
inherited
condition
is
characterized
by
elevated
plasma
calcium
levels
,
relative
or
absolute
hypocalciuria
,
and
normal
to
moderately
elevated
plasma
PTH
level
.
The
disease
is
caused
by
inactivating
mutations
in
the
calcium-sensing
receptor
gene
.
We
describe
a
77
-
year
-old
Italian
man
with
arthritis
secondary
to
CPPD-CDD
and
hypercalcemia
.
Clinical
and
biochemical
data
(
s-
Ca
:
2
.
94
mmol
/
L
;
PTH
:
5
.
9
pmol
/
L
;
24
h
urinary
calcium
:
69
.
6
mg
;
calcium
/
creatinine
clearance
:
0
.
004
)
suggested
the
diagnosis
of
FHH
.
Mild
hypocalciuric
hypercalcemia
was
also
found
in
five
of
seven
relatives
confirming
the
diagnosis
,
of
these
one
showed
chondrocalcinosis
.
It
is
important
to
screen
for
FHH
using
fractional
urinary
excretion
of
calcium
in
subjects
with
CPPD-CDD
associated
to
hypercalcemia
,
this
approach
may
prevent
unnecessary
parathyroidectomy
.
Diseases
Validation
Diseases presenting
"relative or absolute hypocalciuria"
symptom
familial hypocalciuric hypercalcemia
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