{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T05:12:17Z","timestamp":1777093937623,"version":"3.51.4"},"reference-count":29,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,7,19]]},"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:p>Primary hyperparathyroidism (PHPT) is the most common cause of parathyroid hormone (PTH) dependent hypercalcaemia, however there are few reported cases of its co-occurrence in patients with familial hypocalciuric hypercalcaemia (FHH). This case highlights the challenges in managing a rare case of dual pathology. A 49-year-old Caucasian woman with symptoms of hypercalcaemia presented with an adjusted serum calcium of 2.77\u2009mmol\/L and PTH of 11.5\u2009pmol\/L. Neck ultrasound and sestamibi scan were concordant with a left lower parathyroid adenoma, and a preoperative dual-energy X-ray absorptiometry scan confirmed osteopenia. Parathyroidectomy resulted in a PTH reduction from 11.5 pmol\/L to 2.7 pmol\/L. Interestingly, her lowest pre-operative adjusted serum calcium of 2.67\u2009mmol\/L remained unchanged 14 months post-parathyroidectomy. Twenty-four hours urine calcium:creatinine clearance ratio performed postoperatively was low and sequencing analysis of the calcium-sensing receptor gene confirmed the coexistence of FHH. Although surgery is not indicated in FHH, parathyroidectomy may help reduce hypercalcaemia and its associated complications if there is coexistent PHPT.<\/jats:p>","DOI":"10.1136\/bcr-2020-237036","type":"journal-article","created":{"date-parts":[[2020,8,26]],"date-time":"2020-08-26T01:35:33Z","timestamp":1598405733000},"page":"e237036","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Double jeopardy: a patient\u2019s tale of two concurrent hypercalcaemic syndromes"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3198-0879","authenticated-orcid":false,"given":"Aditi","family":"Sharma","sequence":"first","affiliation":[{"name":"Section of Investigative Medicine, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatima","family":"Bahowairath","sequence":"additional","affiliation":[{"name":"Deaprtment of Endocrine and Diabetes, Watford General Hospital, Watford, Hertfordshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chukwuma","family":"Uduku","sequence":"additional","affiliation":[{"name":"Section of Investigative Medicine, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia E","family":"Ostberg","sequence":"additional","affiliation":[{"name":"Deaprtment of Endocrine and Diabetes, Watford General Hospital, Watford, Hertfordshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,8,25]]},"reference":[{"key":"2025082703554261000_13.8.e237036.1","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-198111000-00002"},{"key":"2025082703554261000_13.8.e237036.2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-13-0224"},{"key":"2025082703554261000_13.8.e237036.3","first-page":"193","article-title":"Genetic linkage analysis in familial benign (hypocalciuric) hypercalcemia: evidence for locus heterogeneity","volume":"53","author":"Heath","year":"1993","journal-title":"Am J Hum Genet"},{"key":"2025082703554261000_13.8.e237036.4","doi-asserted-by":"publisher","DOI":"10.1007\/BF00207376"},{"key":"2025082703554261000_13.8.e237036.5","doi-asserted-by":"publisher","DOI":"10.1086\/302202"},{"key":"2025082703554261000_13.8.e237036.6","doi-asserted-by":"publisher","DOI":"10.1038\/ng0792-295"},{"key":"2025082703554261000_13.8.e237036.7","doi-asserted-by":"publisher","DOI":"10.1172\/JCI118335"},{"key":"2025082703554261000_13.8.e237036.8","doi-asserted-by":"publisher","DOI":"10.1097\/MED.0b013e32834c3c7c"},{"key":"2025082703554261000_13.8.e237036.9","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/dds105"},{"key":"2025082703554261000_13.8.e237036.10","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-3442"},{"key":"2025082703554261000_13.8.e237036.11","doi-asserted-by":"publisher","DOI":"10.4158\/EP12284.RA"},{"key":"2025082703554261000_13.8.e237036.12","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.3339"},{"key":"2025082703554261000_13.8.e237036.13","doi-asserted-by":"publisher","DOI":"10.1016\/0092-8674(93)90617-Y"},{"key":"2025082703554261000_13.8.e237036.14","doi-asserted-by":"publisher","DOI":"10.1210\/jc.87.3.1015"},{"key":"2025082703554261000_13.8.e237036.15","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-09-0257"},{"key":"2025082703554261000_13.8.e237036.16","doi-asserted-by":"crossref","unstructured":"Forde HE , Hill AD , Smith D , et al . 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