metricas
covid
Buscar en
Medicina Clínica (English Edition)
Toda la web
Inicio Medicina Clínica (English Edition) New mutation in the calcium-sensing receptor gene as a form of presentation of f...
Journal Information

Statistics

Follow this link to access the full text of the article

Letter to the Editor
New mutation in the calcium-sensing receptor gene as a form of presentation of familial hypocalciuric hypercalcemia type 1
Nueva mutación en el gen del receptor sensible al calcio como forma de presentación de hipercalcemia hipocalciúrica familiar tipo 1
Jorge Rojo Álvaroa,
Corresponding author
jorgerojo23@hotmail.com

Corresponding author.
, Ihintza Larrañaga Unanueb, Ismene Bilbao Garaya
a Servicio de Endocrinología, Hospital Universitario Donostia, Gipuzkoa, Spain
b Servicio de Endocrinología, Hospital de Mendaro, Gipuzkoa, Spain
Read
Not available
Times
was read the article
Total PDF
Total HTML
Share statistics
 array:24 [
  "pii" => "S2387020623004916"
  "issn" => "23870206"
  "doi" => "10.1016/j.medcle.2023.07.009"
  "estado" => "S300"
  "fechaPublicacion" => "2023-12-22"
  "aid" => "6352"
  "copyright" => "Elsevier España, S.L.U.. All rights reserved"
  "copyrightAnyo" => "2023"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "cor"
  "cita" => "Med Clin. 2023;161:552-3"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0025775323004104"
      "issn" => "00257753"
      "doi" => "10.1016/j.medcli.2023.07.004"
      "estado" => "S300"
      "fechaPublicacion" => "2023-12-22"
      "aid" => "6352"
      "copyright" => "Elsevier España, S.L.U."
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Med Clin. 2023;161:552-3"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>"
        "titulo" => "Nueva mutaci&#243;n en el gen del receptor sensible al calcio como forma de presentaci&#243;n de hipercalcemia hipocalci&#250;rica familiar tipo 1"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "552"
            "paginaFinal" => "553"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "New mutation in the calcium-sensing receptor gene as a form of presentation of familial hypocalciuric hypercalcemia type 1"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Jorge Rojo &#193;lvaro, Ihintza Larra&#241;aga Unanue, Ismene Bilbao Garay"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "Jorge"
                "apellidos" => "Rojo &#193;lvaro"
              ]
              1 => array:2 [
                "nombre" => "Ihintza"
                "apellidos" => "Larra&#241;aga Unanue"
              ]
              2 => array:2 [
                "nombre" => "Ismene"
                "apellidos" => "Bilbao Garay"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2387020623004916"
          "doi" => "10.1016/j.medcle.2023.07.009"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623004916?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775323004104?idApp=UINPBA00004N"
      "url" => "/00257753/0000016100000012/v1_202312072233/S0025775323004104/v1_202312072233/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S2387020623004989"
    "issn" => "23870206"
    "doi" => "10.1016/j.medcle.2023.05.028"
    "estado" => "S300"
    "fechaPublicacion" => "2023-12-22"
    "aid" => "6339"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46;"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Med Clin. 2023;161:554"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>"
      "titulo" => "Amyloid polyneuropathy in a patient with Waldenstr&#246;m macroglobulinemia"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "554"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Polineuropat&#237;a amiloidea en un paciente con macroglobulinemia de Waldenstr&#246;m"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:6 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 448
              "Ancho" => 757
              "Tamanyo" => 64506
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Daniel N&#46; Marco, Iban Aldecoa, Daniel Sanchez-Tejerina, Jos&#233; C&#46; Milisenda, Raquel Aranega"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Daniel N&#46;"
              "apellidos" => "Marco"
            ]
            1 => array:2 [
              "nombre" => "Iban"
              "apellidos" => "Aldecoa"
            ]
            2 => array:2 [
              "nombre" => "Daniel"
              "apellidos" => "Sanchez-Tejerina"
            ]
            3 => array:2 [
              "nombre" => "Jos&#233; C&#46;"
              "apellidos" => "Milisenda"
            ]
            4 => array:2 [
              "nombre" => "Raquel"
              "apellidos" => "Aranega"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623004989?idApp=UINPBA00004N"
    "url" => "/23870206/0000016100000012/v2_202401260944/S2387020623004989/v2_202401260944/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2387020623004953"
    "issn" => "23870206"
    "doi" => "10.1016/j.medcle.2023.07.010"
    "estado" => "S300"
    "fechaPublicacion" => "2023-12-22"
    "aid" => "6380"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46;"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Med Clin. 2023;161:551-2"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Atrioventricular block in dilated cardiomyopathy and mutation in emerin gene"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "551"
          "paginaFinal" => "552"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Bloqueo auriculoventricular en miocardiopat&#237;a dilatada y mutaci&#243;n en el gen de la emerina"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "N&#233;stor B&#225;ez-Ferrer, Fel&#237;citas D&#237;az-Flores-Est&#233;vez, Antonia P&#233;rez-Cejas"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "N&#233;stor"
              "apellidos" => "B&#225;ez-Ferrer"
            ]
            1 => array:2 [
              "nombre" => "Fel&#237;citas"
              "apellidos" => "D&#237;az-Flores-Est&#233;vez"
            ]
            2 => array:2 [
              "nombre" => "Antonia"
              "apellidos" => "P&#233;rez-Cejas"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0025775323004530"
        "doi" => "10.1016/j.medcli.2023.07.009"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775323004530?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623004953?idApp=UINPBA00004N"
    "url" => "/23870206/0000016100000012/v2_202401260944/S2387020623004953/v2_202401260944/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "New mutation in the calcium-sensing receptor gene as a form of presentation of familial hypocalciuric hypercalcemia type 1"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#58;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "552"
        "paginaFinal" => "553"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Jorge Rojo &#193;lvaro, Ihintza Larra&#241;aga Unanue, Ismene Bilbao Garay"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "Jorge"
            "apellidos" => "Rojo &#193;lvaro"
            "email" => array:1 [
              0 => "jorgerojo23@hotmail.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Ihintza"
            "apellidos" => "Larra&#241;aga Unanue"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Ismene"
            "apellidos" => "Bilbao Garay"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Endocrinolog&#237;a&#44; Hospital Universitario Donostia&#44; Gipuzkoa&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Endocrinolog&#237;a&#44; Hospital de Mendaro&#44; Gipuzkoa&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Nueva mutaci&#243;n en el gen del receptor sensible al calcio como forma de presentaci&#243;n de hipercalcemia hipocalci&#250;rica familiar tipo 1"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Familial hypocalciuric hypercalcaemia &#40;FHH&#41; is a benign cause of hypercalcaemia&#44; usually asymptomatic&#44; characterised by autosomal dominant inheritance with high penetrance&#46; It is an entity to be considered in the differential diagnosis of hypercalcaemia&#46; Its biochemical pattern consists of mild to moderate hypercalcaemia&#44; high or inappropriately normal parathyroid hormone &#40;PTH&#41; levels&#44; and the presence of hypocalciuria or a calcium&#47;creatinine clearance ratio &#40;CCCR&#41;<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#46; The Ca&#47;Cr ratio<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01 occurs in more than 80&#37; of cases of FHH with a specificity of 88&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">FHH is genetically heterogeneous&#46; FHH type 1 is the most common form and is caused by inactivating mutations in the calcium-sensitive receptor &#40;CaSR&#41; gene residing on the long arm of chromosome 3 &#40;3q21&#46;1&#41;&#46; CaSR modulates PTH secretion and urinary calcium excretion&#46; Most of the mutations identified consist of reduced receptor function or&#44; a truncated and inactive CaSR&#44;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> resulting in the parathyroid glands being less sensitive to calcium&#44; requiring a higher serum calcium concentration to reduce PTH release&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Less commonly&#44; FHH is due to loss-of-function mutations in two other genes&#58; GNA11 and AP2S1&#44; referred to in these cases as FHH type 2 and type 3&#44; respectively&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> These two genes encode two molecules &#40;G alpha 11 and AP-2 sigma 1&#44; respectively&#41; involved in intracellular calcium signalling&#44; participating in the secretion of PTH and renal reabsorption of calcium&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">It is currently unclear whether there are relevant phenotypic differences between the different subtypes of FHH&#44; although it has been suggested that mutations in the AP2S1 gene &#40;FHH3&#41; are responsible for a more severe impairment of calcium homeostasis&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Mutational analysis of CaSR and&#44; in some cases&#44; GNA11 and AP2S1 may be useful to distinguish FHH from other causes of hypercalcaemia such as primary hyperparathyroidism &#40;PHP&#41; in borderline cases&#46; Given the relative frequency of FHH&#44; it has been suggested that sequencing of the CaSR and AP2S1 genes should be performed first and sequencing of GNA11 only if the others do not reveal pathogenic mutations&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">We report 4 cases of FHH in the same family derived from a new pathogenic missense variant in the CaSR gene&#46; The index case was a 43-year-old male from Paraguay&#44; referred for consultation due to a several-year history of hypercalcaemia<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>11<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; with no family history of hypercalcaemia&#46; He had normal PTH levels and a Ca&#47;Cr ratio of 0&#46;01 &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; He had no history of renal colic or bone fractures&#46; In view of the suspicion of FHH&#44; genetic testing was requested which showed a missense variant c&#46;2030G&#62;A&#59;p&#46;&#40;Cys677Tyr&#41;&#44; in which the substitution of a Guanine for an Adenine generated&#44; in turn&#44; the substitution of the amino acid Cysteine for Tyrosine at residue 677 of the CaSR protein&#46; This variant was not described in the databases consulted&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> The Cys677 residue is highly conserved between different species&#44; and the computer prediction tools used suggest that it has a pathogenic effect on protein function&#46; The variant is located in a region considered to be a hot spot&#44; where missense variants with a likely pathogenic effect are abundant and was therefore classified as a likely pathogenic variant&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The study was extended to relatives living in Spain &#40;daughter&#44; brother and nephew&#41;&#44; all of whom also had asymptomatic hypercalcaemia &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; and genetic testing compatible with the same mutation in all of them&#44; reflecting the high penetrance of the mutation&#46; The patient had 5 other asymptomatic siblings in his home country who had not been studied&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The reported cases represent a new pathogenic variant not described in the Caucasian population&#59; therefore&#44; it is possible that mutations of this type will be identified more and more frequently&#46; It is essential to recognise these patients in order to avoid unnecessary diagnostic and therapeutic studies&#44; especially in view of their good prognosis and the absence of associated comorbidity&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical considerations</span><p id="par0040" class="elsevierStylePara elsevierViewall">Informed consent has been obtained from patients&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Funding</span><p id="par0045" class="elsevierStylePara elsevierViewall">None&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflict of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">None&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:4 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Ethical considerations"
        ]
        1 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Funding"
        ]
        2 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Conflict of interest"
        ]
        3 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "multimedia" => array:1 [
      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0010"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Index case&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Brother&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Daughter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Nephew&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total calcium &#40;mg&#47;dl&#41; &#40;NV 8&#44;6&#8211;10&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PTH &#40;pg&#47;mL&#41; &#40;NV 10&#8722;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25-OH-vitamin D &#40;ng&#47;mL&#41; &#40;NV 30&#8722;80&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Urine calcium &#40;mg&#47;24<span class="elsevierStyleHsp" style=""></span>h&#41; &#40;NV 100&#8722;320&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">118&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">102&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ca&#47;Cr Ratio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3444906.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Laboratory results&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical lessons from the calcium-sensing receptor"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "E&#46;M&#46; Brown"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/ncpendmet0388"
                      "Revista" => array:5 [
                        "tituloSerie" => "Nat Rev Endocrinol&#46;"
                        "fecha" => "2007"
                        "volumen" => "3"
                        "paginaInicial" => "122"
                        "paginaFinal" => "133"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "International Union of Basic and Clinical Pharmacology&#46; CVIII&#46; Calcium-sensing receptor nomenclature&#44; pharmacology&#44; and function"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Leach"
                            1 => "F&#46;M&#46; Hannan"
                            2 => "T&#46;M&#46; Josephs"
                            3 => "A&#46;N&#46; Keller"
                            4 => "T&#46;C&#46; Moller"
                            5 => "D&#46;T&#46; Ward"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1124/pr.119.018531"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pharmacol Rev&#46;"
                        "fecha" => "2020"
                        "volumen" => "72"
                        "paginaInicial" => "558"
                        "paginaFinal" => "664"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32467152"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mutations affecting G-protein subunit &#945;11 in hypercalcemia and hypocalcemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;A&#46; Nesbit"
                            1 => "F&#46;M&#46; Hannan"
                            2 => "S&#46;A&#46; Howles"
                            3 => "V&#46;N&#46; Babinsky"
                            4 => "R&#46;A&#46; Head"
                            5 => "T&#46; Cranston"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1300253"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med&#46;"
                        "fecha" => "2013"
                        "volumen" => "368"
                        "paginaInicial" => "2476"
                        "paginaFinal" => "2486"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23802516"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Familial hypocalciuric hypercalcemia and related disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;Y&#46; Lee"
                            1 => "D&#46;M&#46; Shoback"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.beem.2018.05.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Best Pract Res Clin Endocrinol Metab&#46;"
                        "fecha" => "2018"
                        "volumen" => "32"
                        "paginaInicial" => "609"
                        "paginaFinal" => "619"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30449544"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Adam MP&#44; Mirzaa GM&#44; Pagon RA&#44; Wallace SE&#44; Bean LJH&#44; Gripp KW&#44; et al&#46;&#44; editors&#46; GeneReviews&#174; &#91;Internet&#93;&#46; Seattle &#40;WA&#41;&#58; University of Washington&#44; Seattle&#59; 1993-2023 &#91;accessed 12 Jan 2023&#93;&#46; Available from&#58; <a target="_blank" href="https://www.ncbi.nlm.nih.gov/books/NBK1116/">https&#58;&#47;&#47;www&#46;ncbi&#46;nlm&#46;nih&#46;gov&#47;books&#47;NBK1116&#47;</a>&#46;"
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/23870206/0000016100000012/v2_202401260944/S2387020623004916/v2_202401260944/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "43309"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/23870206/0000016100000012/v2_202401260944/S2387020623004916/v2_202401260944/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623004916?idApp=UINPBA00004N"
]
Article information
ISSN: 23870206
Original language: English
The statistics are updated each day

Follow this link to access the full text of the article

es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos