Table 3.
Clinical features differentiating PHPT from FHH
| PHPT | FHH | |
|---|---|---|
| Age at presentation | Older | Younger |
| Family history | ± † | +++ |
| Symptoms | ++ | – |
| Hypercalcaemia | +++ | ++ |
| Hyperparathyroidism | +++ | ± |
| Calcium/creatinine clearance ratio | >1% | <1% |
| Vitamin D insufficiency | ++ | – |
| Raised alkaline phosphatase | ++ | – |
| Ultrasound scan | +++ | – |
| 99mTc-sestamibi-SPECT/CT | +++ | – |
| Osteopenia/osteoporosis | ++ | – |
| Renal calculi | ++ | – |
| Peptic ulcers | + | – |
| Curative parathyroidectomy | +++ | – |
Strength of association: +++ = very strong, ++ = moderate, + = mild, − = less likely
†Family history may be present in familial forms of PHPT