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Previous Volume 351:2237-2238 November 18, 2004 Number 21 Next

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To the Editor: Inappropriate elevation of serum parathyroid hormone is present in both acquired and familial hypocalciuric hypercalcemia, and as Pallais et al. (July 22 issue)¹ note, a low ratio of urinary calcium to creatinine clearance separates these disorders from primary hyperparathyroidism. This point is extremely important, because glucocorticoids may control the acquired form,¹ and parathyroidectomy is rarely necessary for familial hypocalciuric hypercalcemia.²

We recently diagnosed familial hypocalciuric hypocalcemia in a 26-year-old woman thought to have primary hyperparathyroidism. Hypercalcemia (calcium, 12.0 mg per deciliter) associated with an inappropriate elevation of serum intact parathyroid hormone (5.8 pmol per liter; normal range, . . . [Full Text of this Article]

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