Efficacy of calcium excretion and calcium/creatinine clearance ratio in the differential diagnosis of familial hypocalciuric hypercalcemia and primary hyperparathyroidism.


Journal

Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541

Informations de publication

Date de publication:
05 2019
Historique:
received: 25 04 2018
revised: 08 08 2018
accepted: 21 11 2018
pubmed: 17 12 2018
medline: 24 11 2020
entrez: 17 12 2018
Statut: ppublish

Résumé

Twenty-four-hour renal calcium-excretion (CE) and calcium/creatinine-clearance-ratio (CCCR), respectively, are widely used to rule out familial hypocalciuric hypercalcemia (FHH) in patients with suspected primary hyperparathyroidism before surgery. The aim was to evaluate the practicability of CE compared to CCCR. We analyzed biochemical parameters, surgical treatment, gene mutation results, and long-term follow-up data of 198 patients (including 14 patients with FHH) and the discriminative power of CE and CCCR. Twenty four patients (12.1%) had a low CE and 35 patients (20.2%) had a CCCR indicating FHH. However, eight patients with FHH (57.1%) had a normal or increased CE. Correspondingly, only eight cases of FHH (57.1%) were correctly predicted by CCCR. Sensitivity/specificity were 42.9%/89.9% for CE and 64.3%/79.9% for CCCR, showing no statistical differences (P = 0.482) between both methods. Neither CE nor CCCR was able to distinguish between PHPT and FHH but may help to narrow down potential FHH patients.

Sections du résumé

BACKGROUND
Twenty-four-hour renal calcium-excretion (CE) and calcium/creatinine-clearance-ratio (CCCR), respectively, are widely used to rule out familial hypocalciuric hypercalcemia (FHH) in patients with suspected primary hyperparathyroidism before surgery. The aim was to evaluate the practicability of CE compared to CCCR.
PATIENTS AND METHODS
We analyzed biochemical parameters, surgical treatment, gene mutation results, and long-term follow-up data of 198 patients (including 14 patients with FHH) and the discriminative power of CE and CCCR.
RESULTS
Twenty four patients (12.1%) had a low CE and 35 patients (20.2%) had a CCCR indicating FHH. However, eight patients with FHH (57.1%) had a normal or increased CE. Correspondingly, only eight cases of FHH (57.1%) were correctly predicted by CCCR. Sensitivity/specificity were 42.9%/89.9% for CE and 64.3%/79.9% for CCCR, showing no statistical differences (P = 0.482) between both methods.
CONCLUSION
Neither CE nor CCCR was able to distinguish between PHPT and FHH but may help to narrow down potential FHH patients.

Identifiants

pubmed: 30554440
doi: 10.1002/hed.25568
doi:

Substances chimiques

Parathyroid Hormone 0
Creatinine AYI8EX34EU
Calcium SY7Q814VUP

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1372-1378

Informations de copyright

© 2018 Wiley Periodicals, Inc.

Auteurs

Jagdeep Singh Bhangu (JS)

Section of Endocrine Surgery, Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.

Andreas Selberherr (A)

Section of Endocrine Surgery, Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.

Lindsay Brammen (L)

Section of Endocrine Surgery, Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.

Christian Scheuba (C)

Section of Endocrine Surgery, Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.

Philipp Riss (P)

Section of Endocrine Surgery, Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.

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