Andrade Navarro María T, Pérez González Elena, Cantos Pastor Virginia, Marín Patón Mariano, Lara Ruiz Alfonso
Instituto Hispalense de Pediatría, Sevilla, España.
Nefrología Pediátrica, Hospital Universitario Virgen Macarena, Sevilla, España.
Arch Argent Pediatr. 2018 Dec 1;116(6):e757-e761. doi: 10.5546/aap.2018.e757.
The finding of persistent hypercalcemia suggests doing other medical tests to find the cause. Familial hypocalciuric hypercalcemia is usually benign and it requires no treatment. It is important to do CASR gene sequencing to avoid unnecessary treatments. We report a 12-year-old child, asymptomatic, with calcemia between 11.4 and 12.2 mg/dl. His father and two brothers presented asymptomatic hypercalcemia. The blood test with magnesium, phosphorus, 25(OH)Vit D was normal, remarkable normal parathyroid hormone for the level of hypercalcemia. Urinary calcium/creatinine ratio was 0,11 mg/dl and 24-hour urinary calcium was 1,8 mg/kg per day. Abdominal and parathyroid ecography, long bone radiographs and densitometry were normal. Genetic study showed a mutation, c.1651A>G, in exon 6 of the calciumsensing receptor gene, confirmed in father and brothers, too.
持续性高钙血症的发现提示需进行其他医学检查以查找病因。家族性低钙尿性高钙血症通常为良性,无需治疗。进行钙敏感受体(CASR)基因测序以避免不必要的治疗很重要。我们报告一名12岁无症状儿童,血钙水平在11.4至12.2mg/dl之间。他的父亲和两个兄弟有无症状性高钙血症。镁、磷、25(OH)维生素D的血液检查结果正常,甲状旁腺激素水平对于该高钙血症程度而言显著正常。尿钙/肌酐比值为0.11mg/dl,24小时尿钙为1.8mg/kg/天。腹部及甲状旁腺超声、长骨X线片和骨密度测定均正常。基因研究显示钙敏感受体基因第6外显子存在c.1651A>G突变,其父亲和兄弟也被证实有该突变。