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Insulinoma — SCE Endocrinology MCQ

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HardDiabetesInsulinomaSCE Endocrinology

A 39-year-old has lifelong mild hypercalcaemia, normal renal function, non-suppressed PTH and no nephrolithiasis. Her mother and sister have similar results. Urine calcium:creatinine clearance ratio is 0.006. What is the most likely diagnosis?

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Correct answer: D — Familial hypocalciuric hypercalcaemia

Lifelong familial mild hypercalcaemia with relative hypocalciuria and a calcium:creatinine clearance ratio below about 0.01 strongly suggests familial hypocalciuric hypercalcaemia. Recognising FHH is important because parathyroidectomy usually does not correct the hypercalcaemia; genetic confirmation may be appropriate when results and family history support the diagnosis.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/diabetes-and-other-endocrinal-nutritional-and-metabolic-conditions