Familial hypocalciuric hypercalcemia (FHH)

Rare benign disorder due to loss of function mutations in the calcium-sensing receptor (CASR) gene.

24 hour urine calcium on a normal calcium diet is usually very low at less than 100 mg, with the calcium-to-creatinine clearance ratio of less than 0.010.

Frequently associated with a positive family history and patients may have hypercalcemia at birth.

Almost all patients develop hypercalcemia by the third decade.

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