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Endocrine Abstracts (2025) 110 EP311 | DOI: 10.1530/endoabs.110.EP311

1Hedi Chaker University Hospital, Endocrinology Department, Sfax, Tunisia


JOINT3398

Introduction: Familial hypocalciuric hypercalcemia (FHH), also known as Marx syndrome, is a benign hereditary condition with autosomal dominant transmission. Here, we describe a case of FHH diagnosed in the context of the management of Sjögren’s syndrome.

Case Report: A 41-year-old female patient with no significant medical history presented with ocular and oral dryness. The diagnosis of Sjögren’s syndrome was confirmed based on a Grade 4 Chisholm lymphocytic sialadenitis found on labial biopsy and the presence of positive anti-SSA antibodies. A phosphocalcium assessment repeatedly showed hypercalcemia (2.7–2.83 mmol/l) with normal phosphatemia and alkaline phosphatases, along with hypocalciuria confirmed on multiple occasions (0.45–1.3 mmol/24h). Given this moderate and asymptomatic hypercalcemia, an etiological investigation was conducted, ruling out:Primary hyperparathyroidism (normal PTH, unremarkable ultrasound), Multiple myeloma (normal serum immunoelectrophoresis), Sarcoidosis (normal angiotensin-converting enzyme levels), Drug-induced hypercalcemia (no relevant medication history) The presence of hypocalciuria further supported the diagnosis of familial hypocalciuric hypercalcemia (FHH).

Discussion: Renal involvement in Sjögren’s syndrome can lead to hypercalciuria due to tubular dysfunction. The uniqueness of this case lies in the unexpected finding of hypocalciuria, which, after an extensive workup, was attributed to FHH. FHH is associated with an inactivating mutation of the calcium-sensing receptor (CaSR) gene, located on chromosome 3, necessitating screening of other family members

Volume 110

Joint Congress of the European Society for Paediatric Endocrinology (ESPE) and the European Society of Endocrinology (ESE) 2025: Connecting Endocrinology Across the Life Course

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