Table 3.
Comparison of clinical and biochemical parameters for patients with 24HD or other hypercalcemia disorders
| Parameter | 24HD (n = 9) | All non-24HD disorders (n = 28) | P valuea | EVT (n = 6) | P valuea | Lymphoma (n = 7) | P valuea | Sarcoidosis (n = 15) | P valuea | Global P valueb |
|---|---|---|---|---|---|---|---|---|---|---|
| Age at onset of symptoms, years | 14 (1, 35) | 63 (56, 79) | .001 | 52 (30, 56) | .09 | 80 (78, 88) | .005 | 59 (56, 67) | .004 | <.001 |
| Family history of symptoms, n(%) | 8 (88.9) | 5/24 (20.8) | <.001 | 4 (66.7) | .53 | 0/5 (0) | .003 | 1/13 (7.7) | <.001 | <.001 |
| Imaging findings, n(%) | ||||||||||
| Stones, n(%) | 5 (55.6) | 6/15 (40.0) | .68 | 0/2 (0) | … | 2/5 (40.0) | … | 4/8 (50.0) | … | .73 |
| Nephrocalcinosis, n(%) | 8 (88.9) | 1/16 (6.3) | <.001 | 1/2 (50.0) | .35 | 0/6 (0) | .001 | 0/8 (0) | <.001 | <.001 |
| Cysts, n(%) | 7 (77.8) | 7/15 (46.7) | .21 | 0/2 (0) | … | 4/5 (80.0) | … | 3/8 (37.5) | … | .11 |
| Z-score | ||||||||||
| Left hip | −0.60 (−1.70, 0.60) | −0.25 (−0.70, 1.30) | .47 | 0.45 (−0.90, 1.80) | … | −0.70 () | … | 0.20 (−0.70, 1.30) | … | .81 |
| Right hip | −0.70 (−1.70, 0.40) | 0.80 (−0.30, 1.85) | .34 | 0.75 (−0.80, 2.30) | … | … | … | 0.80 (0.20, 1.40) | … | .56 |
| Spine (total lumbar) | −0.50 (−0.80, 0.70) | 1.20 (0.80, 2.10) | .01 | 1.10 (0.70, 1.50) | … | 0.80 () | … | 2.10 (0.90, 2.30) | … | .06 |
| Peak serum calcium, mg/dLd | 10.9 (10.6, 11.4) | 11.5 (10.9, 13.0) | .11 | 10.9 (10.6, 11.2) | .95 | 13.6 (11.3, 15.4) | .01 | 11.6 (10.8, 12.7) | .19 | .03 |
| Lowest PTH, pg/mL | 6.6 (6.0, 14.0) | 13.0 (8.6, 18.0) | .08 | 15.0 (12.0, 19.0) | … | 12.0 (7.9, 15.0) | … | 14.0 (7.9, 20.0) | … | .25 |
| Calcium at lowest PTH, mg/dL | 10.6 (10.4, 10.8) | 11.0 (10.4, 11.8) | .13 | 10.8 (10.6, 11.0) | … | 11.3 (11.0, 14.9) | … | 10.9 (10.1, 12.0) | … | .15 |
| Phosphorous at lowest PTH, %PRR | 96 (71, 96) | 80 (71, 89) | .43 | 90 (80, 94) | … | 71 (67, 91) | … | 80 (73, 84) | … | .25 |
| Peak serum phosphorous, %PRR | 107 (98, 108) | 84 (81, 91) | .01 | 90 (89, 94) | .11 | 82 (78, 91) | .04 | 84 (76, 89) | .02 | .03 |
| Alkaline phosphatasec, %PRR | 55 (30, 70) | 62 (51, 72) | .48 | 64 (48, 126) | … | 52 (48, 76) | … | 63 (56, 69) | … | .66 |
| Peak 25(OH)D3, ng/mL | 56 (54, 61) | 37 (29, 47) | .09 | 223 (109, 371) | .002 | 39 (35, 44) | .01 | 31 (28, 37) | .002 | <.001 |
| Peak 1,25(OH)2D3, pg/mL | 145 (114, 149) | 87 (69, 133) | .05 | 67 (46, 80) | … | 90 (82, 143) | … | 95 (70, 150) | … | .09 |
| Urinary spot test, mg/L | ||||||||||
| Calcium, mg/L | 207 (93, 325) | 214 (144, 288) | .78 | 160 () | … | … | … | 267 (127, 308) | … | .81 |
| Creatinine, mg/L | 1111 (370, 1525) | 870 (848, 1,679) | .52 | 625 (380, 870) | … | … | … | 1679 (848, 2048) | … | .26 |
| Calcium:creatinine ratio | 0.24 (0.21, 1.70) | 0.17 (0.14, 0.18) | .047 | 0.18 () | … | … | … | 0.15 (0.13, 0.18) | … | .10 |
| 24-Hour urinary test | ||||||||||
| Calcium, mg per 24 h | 248 (72, 407) | 385 (226, 521) | .23 | 237 (226, 399) | … | 385 (375, 536) | … | 391 (221, 521) | … | .47 |
| Creatinine, mg per 24 h | 1285 (351, 2219) | 1122 (832, 1536) | >.99 | 984 (811, 1157) | … | 1184 (832, 1536) | … | 1122 (1102, 1541) | … | .97 |
| Phosphorus, mg per 24 h | 1118 (311, 1332) | 956 (757, 1154) | >.99 | 757 () | … | … | … | 1154 () | … | .67 |
| Calcium excretion, mg/kg per h | 4.47 (3.52, 5.17) | 4.53 (2.67, 5.73) | >.99 | 4.53 (2.99, 7.33) | … | 5.27 (4.47, 7.20) | … | 4.24 (2.50, 5.25) | … | .53 |
| Hypercalciuria, n(%) | 8 (88.9) | 10/18 (55.6) | .19 | 2/4 (50.0) | … | 3/3 (100) | … | 5/11 (45.5) | … | .12 |
Reported statistics are median (IQR) for continuous variables and n (%) for categorical variables. Results followed by empty brackets indicate that only 1 sample was available for analysis. Laboratory measures taken closest to diagnosis. P values in bold indicate statistical significance at the 0.05 alpha level.
… Indicates that the global P value was not statistically significant using the Kruskal–Wallis test, so no further between-group tests were performed.
Abbreviations: 24HD, 24-hydroxylase deficiency; EVT, exogenous vitamin D toxicity; IQR, interquartile range; PTH, parathyroid hormone. %PRR = % of peak reference range.
a Comparison with 24HD values.
b Global P value (comparison across 4 disease groups).
c Lab taken closest to peak calcium.
d Reference intervals for serum calcium are 9.3-10.6 mg/dL for ages 1-17 and 8.6-10.0 mg/dL for ages 18-59.