# E.4 Concept Enumerations for caseSignificanceId

This concept enumeration represents a value that can be applied to the *description*.caseSignificanceId field. This is used to indicate whether the text of the term can be modified to by switching characters from upper to lower case (or vice-versa). The Table below shows the current set of values for this concept enumeration.

**Case significance (core metadata concept) (900000000000447004)**

<table data-full-width="true"><thead><tr><th width="250.6771240234375"></th><th></th></tr></thead><tbody><tr><td><a href="http://snomed.info/id/900000000000017005">900000000000017005 |Entire term case sensitive (core metadata concept)|</a></td><td>The text of the description.term must be presented in the case in which it is specified.</td></tr><tr><td><a href="http://snomed.info/id/900000000000020002">900000000000020002 |Only initial character case insensitive (core metadata concept)|</a></td><td>The initial character of the description.term is case insensitive and can be changed from upper to lower case (or vice-versa) if appropriate to the context in which it is used. This applies only to the first character of the term as a whole, not to the initial character of other words in the term.</td></tr><tr><td><a href="http://snomed.info/id/900000000000448009">900000000000448009 |Entire term case insensitive (core metadata concept)|</a></td><td>The entire description.term is case insensitive and can be can be changed from upper to lower case (or vice-versa) if appropriate to the context in which it is used.</td></tr></tbody></table>

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