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Plasma 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and parathyroid hormone in familial hypocalciuric hypercalcemia and primary hyperparathyroidism.
[familial hypocalciuric hypercalcemia]
Familial
hypocalciuric
hypercalcemia
(
FHH
)
is
a
lifelong
,
benign
,
inherited
condition
caused
by
inactivating
mutations
in
the
calcium-sensing
receptor
(
CASR
)
gene
.
Both
FHH
and
primary
hyperparathyroidism
(
PHPT
)
are
characterized
by
elevated
P-
calcium
,
normal
or
elevated
plasma-
parathyroid
hormone
(
P-
PTH
)
,
and
typically
normal
renal
function
.
In
PHPT
,
vitamin
D
metabolism
is
typically
characterized
by
low
plasma
levels
of
25
-
hydroxyvitamin
D
(
25
OHD
)
,
and
high
plasma
levels
of
1
,
25
-
dihydroxyvitamin
D
(
1
,
25
(
OH
)
(
2
)
D
)
.
In
FHH
,
the
vitamin
D
metabolism
is
not
very
well
known
.
To
compare
and
evaluate
plasma
25
OHD
,
1
,
25
(
OH
)
(
2
)
D
,
and
PTH
in
FHH
and
PHPT
.
Cross-sectional
study
.
About
66
FHH
patients
with
mutations
in
the
CASR
gene
,
147
patients
with
surgically
verified
PHPT
,
and
46
controls
matched
to
FHH
patients
according
to
age
(
+
/
-
5
years
)
,
sex
,
and
season
.
All
patients
had
a
P-
creatinine
<
140
micromol
/
l
.
We
measured
P-
calcium
,
P-Ca
(
2
)
(
+
)
,
P-
albumin
,
P-
creatinine
,
P-
phosphate
,
P-
magnesium
,
and
P-
PTH
by
standard
laboratory
methods
.
P-
25
OHD
and
P-
1
,
25
(
OH
)
(
2
)
D
were
measured
by
RIA
or
enzyme
immunoassay
.
In
FHH
,
all
protein-coding
exons
in
the
CASR
gene
were
sequenced
and
aligned
to
GenBank
reference
sequence
NM
_
000388
.
2
.
PHPT
patients
had
higher
body
mass
index
(
2
p
<
0
.
01
)
,
together
with
higher
P-
PTH
(
2
p
<
0
.
01
)
and
P-
1
,
25
(
OH
)
(
2
)
D
(
2
p
<
0
.
01
)
compared
with
FHH
patients
.
The
groups
had
similar
levels
of
P-Ca
(
2
)
(
+
)
and
of
P-
25
OHD
.
The
phenotypic
expression
of
the
CASR
mutations
(
as
determined
by
the
degree
of
hypercalcemia
)
did
not
influence
the
levels
of
P-
1
,
25
(
OH
)
(
2
)
D
.
Even
though
P-
calcium
and
P-
25
OHD
were
comparable
,
P-
1
,
25
(
OH
)
(
2
)
D
and
P-
PTH
differed
between
FHH
and
PHPT
.
Diseases
Validation
Diseases presenting
"high plasma levels"
symptom
fabry disease
familial hypocalciuric hypercalcemia
homocystinuria without methylmalonic aciduria
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