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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
"arthritis"
symptom
acute rheumatic fever
child syndrome
congenital adrenal hyperplasia
cystinuria
familial hypocalciuric hypercalcemia
familial mediterranean fever
focal myositis
harlequin ichthyosis
homocystinuria without methylmalonic aciduria
inclusion body myositis
lamellar ichthyosis
malignant atrophic papulosis
pyomyositis
sneddon syndrome
trochlear dysplasia
typhoid
wiskott-aldrich syndrome
This symptom has already been validated