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Familial hypocalciuric hypercalcemia (FHH) is an inherited condition that can cause hypercalcemia, a serum calcium level typically above 10.2 mg/dL; although uncommon. [1] It is also known as familial benign hypocalciuric hypercalcemia (FBHH) where there is usually a family history of hypercalcemia which is mild, a urine calcium to creatinine ratio <0.01, and urine calcium <200 mg/day ...
Like hypocalcemia, hypercalcemia can be non-severe and present with no symptoms, or it may be severe, with life-threatening symptoms. Hypercalcemia is most commonly caused by hyperparathyroidism and by malignancy, and less commonly by vitamin D intoxication, familial hypocalciuric hypercalcemia and by sarcoidosis. [2]
Chronic elevation of calcium with absent or mild symptoms often points to primary hyperparathyroidism or Familial hypocalciuric hypercalcemia. For those who has underlying malignancy, the cancers may be sufficiently severe to show up in history and examination to point towards the diagnosis with little laboratory investigations.
Mutations that inactivate a CaSR gene cause familial hypocalciuric hypercalcemia (FHH) (also known as familial benign hypercalcemia because it is generally asymptomatic and does not require treatment), [22] when present in heterozygotes. Patients who are homozygous for CaSR inactivating mutations have more severe hypercalcemia. [23]
A number of genetic conditions including multiple endocrine neoplasia syndromes, hyperparathyroidism-jaw tumor syndrome, [18] familial hypocalciuric hypercalcemia, [19] neonatal severe hyperparathyroidism also increase the risk. [1] Parathyroid adenomas have been linked with DDT although a causal link has not yet been established. [20]
Hypocalciuria is a low level of calcium in the urine.It is a significant risk factor for predicting eclampsia in pregnancy. [1] The most common causes for hypocalciuria is either thiazide diuretics or reduced dietary intake of calcium.
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The most common causes of hypercalcemia are certain types of cancer, hyperparathyroidism, hyperthyroidism, pheochromocytoma, excessive ingestion of vitamin D, sarcoidosis, and tuberculosis. [3] Hyperparathyroidism and malignancy are the predominant causes. [14] It can also be caused by muscle cell breakdown, prolonged immobilization ...