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CAU<br />

8594<br />

CAF<br />

8379<br />

An interpretive report will be provided.<br />

Clinical References: 1. Hendy GN, D'Souza-Li L, Yang B, et al: Mutations of the calcium-sensing<br />

receptor (CASR) in familial hypocalciuric hypercalcemia, neonatal severe hypocalciuric<br />

hyperparathyroidism, and autosomal dominant hypocalcemia. Hum Mutat 2000 Oct;16(4):281-296. The<br />

authors maintain a CASR polymorphism/mutation database: http://www.casrdb.mcgill.ca/ 2. Lienhardt A,<br />

Bai M, Lgarde JP, et al: Activating mutations of the calcium-sensing receptor: management of<br />

hypocalcemia. J Clin Endocrinol Metab 2001 Nov;86(1):5313-5323 3. Hu J, Spiegel AM: Naturally<br />

occurring mutations of the extracellular Ca2+ -sensing receptor: implications for its structure and<br />

function. Trends Endocrinol Metab 2003 Aug;14(6):282-288 4. Naesens M, Steels P, Verberckmoes R, et<br />

al: Bartter's and Gitelman's syndromes: from gene to clinic. Nephron Physiol 2004;96(3):65-78 5. Egbuna<br />

OI, Brown EM: Hypercalcaemic and hypocalcaemic conditions due to calcium-sensing receptor<br />

mutations. Best Pract Res Clin Rheumatol 2008; 22:129-148<br />

Calcium, 24 Hour, Urine<br />

Clinical Information: Calcium is the fifth most common element in the body. It is a fundamental<br />

element necessary to form electrical gradients across membranes, an essential cofactor for many enzymes,<br />

and the main constituent in bone. Under normal physiologic conditions, the concentration of calcium in<br />

serum and in cells is tightly controlled. Calcium is excreted in both urine and feces.<br />

Useful For: Identification of abnormal physiologic states causing excess or suppressed excretion of<br />

calcium, such as hyperparathyroidism, vitamin D abnormality, diseases that destroy bone, prostate cancer,<br />

and drug treatment, such as thiazide therapy<br />

Interpretation: Increased urinary excretion of calcium accompanies hyperparathyroidism, vitamin D<br />

intoxication, diseases that destroy bone (such as multiple myeloma), metastasis from prostatic cancer, and<br />

following calcium supplementation. Patients with absorptive hypercalciuria (increased gut absorption)<br />

will have lowered urine calcium with dietary restriction and, therefore, can be differentiated from patients<br />

with hypercalciuria caused by hyperparathyroidism, hyperthyroidism, Paget's disease, or "renal leak" type<br />

of calciuria as seen in renal tubular acidosis. Thiazide drugs tend to reduce excretion of calcium. For<br />

individuals consuming an average daily intake of 600 mg to 800 mg of calcium per day, the normal daily<br />

excretion of calcium is: -25 mg to 300 mg for men -20 mg to 275 mg for women<br />

Reference Values:<br />

Males: 25-300 mg/specimen*<br />

Females: 20-275 mg/specimen*<br />

Hypercalciuria: >350 mg/specimen<br />

*Values are for persons with average calcium intake (ie, 600-800 mg/day).<br />

Clinical References: Rockwell GF, Morgan MJ, Braden G, et al: Preliminary observations of<br />

urinary calcium and osteopontin excretion in premature infants, term infants and adults. Neonatology<br />

2008;93(4): 241-245<br />

Calcium, Feces<br />

Clinical Information: Calcium is the fifth most common element in the body. It is a fundamental<br />

element necessary to form electrical gradients across membranes, it is an essential cofactor for many<br />

enzymes, and it is the main constituent in bone. Under normal physiologic conditions, the concentration<br />

of calcium in serum and in cells is tightly controlled. Calcium is excreted in both the urine and the feces.<br />

Useful For: Identification of abnormal physiologic states causing excess or suppressed absorption or<br />

excretion of calcium<br />

Interpretation: Increased fecal excretion of calcium is observed in diseases involving high calcium<br />

turnover such as hyperparathyroidism, vitamin D intoxication, diseases that destroy bone (such as<br />

multiple myeloma), metastasis from prostatic cancer, and following calcium supplementation. Patients<br />

with absorptive hypercalciuria (increased gut absorption) will have low fecal calcium with dietary<br />

Current as of January 4, 2013 7:15 pm CST 800-533-1710 or 507-266-5700 or <strong>Mayo</strong><strong>Medical</strong><strong>Laboratories</strong>.com Page 350

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