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Would you expect cinacalcet to lower calcium levels in a patient with Familial Hypocalciuric Hypercalcemia (FHH)?
If a patient who has Familial Hypocalciuric Hypercalcemia (FHH) is misdiagnosed as PHPT (Primary Hyperparathyroidism) and treated with Cinacalcet, will it improve the calcium levels? If not, can a therapeutic trial of Cinacalcet and failure to lower calcium, be used as therapeutic trial/ diagnostic test for FHH?
Answer from: at Academic Institution
The hypercalcemia in FHH is not primarily driven by overactive PTH secretion, so targeting the CaSR pharmacologically would not address the underlying pathophysiology. However, I suppose inducing hypoparathyroidism with Cinacalcet would induce calciuria, though at the expense of hypocalcemia.
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Answer from: at Community Practice
An interesting recent study, however, reported on 3 cases of FHH-1 and short QT in which PTH and calcium responded to cinacalcet.Cuny et al., PMID 37602721