FHH - Familial Hypocalciuric Hypercalcaemia

FHH

This is an interesting topic for anyone with parathyroid disease.

The interest in FHH comes from the fact that it is one of the causes of an elevated calcium level so should be considered by your doctor as part of the differential diagnosis.

The important point about it is that the parathyroid glands are normal... The elevated calcium of FHH does not for reasons that are unclear cause symptoms in the way that a similar level from parathyroid disease would.  There is no cure for FHH and the elevated calcium is permanent and not in any way a problem.

If the diagnosis of FHH is missed and you end up having surgery nothing abnormal will found the surgery will achieve precisely nothing.

FHH is excluded by checking a 24 hour urine collection and measuring the amount of calcium excreted in the urine.  This is a very important test.

FHH patients have a low level of urine calcium excretion - usually <100mg per 24 hours.

Other hints that this condition is present are:

1. Only mild elevation of calcium which has been stable over time
2. Young age
3. Patients with a family history of 'parathyroid disease'


Nowadays if there is doubt there is a genetic test to exclude FHH however this takes a long time to get done and in my view is generally not necessary.




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