Comparison of Commercially Available Parathyroid Hormone Immunoassays in the Differential Diagnosis of Hypercalcemia Due to Primary Hyperparathyroidism or Malignancy
Authors: LAWRENCE G. RAISZ
Journal: Annals of Internal Medicine (1979)

Brief Reports1 November 1979Comparison of Commercially Available Parathyroid Hormone Immunoassays in the Differential Diagnosis of Hypercalcemia Due to Primary Hyperparathyroidism or MalignancyLAWRENCE G. RAISZ, M.D., CHAITANYA H. YAJNIK, M.D., RICHARD S. BOCKMAN, M.D., BRUCE F. BOWER, M.D.LAWRENCE G. RAISZ, M.D., CHAITANYA H. YAJNIK, M.D., RICHARD S. BOCKMAN, M.D., BRUCE F. BOWER, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-91-5-739 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe measurement of immunoreactive parathyroid hormone (iPTH) has become an important part of the differential diagnosis of hypercalcemia. High values in the absence of renal failure are considered diagnostic of primary hyperparathyroidism. It has been suggested that the finding of normal iPTH in the presence of elevated serum calcium concentration also should be considered diagnostic of primary hyperparathyroidism, on the assumption that iPTH should be suppressed if hypercalcemia were due to another cause (1, 2). However, normal or even somewhat elevated iPTH values have been reported in patients with hypercalcemia due to malignancy (3, 4). These values have been ascribed...References1. ARNAUDTSAOLITTLEDIKE CHT. Radioimmunoassay of human parathyroid hormone in serum. J Clin Invest. 1971;50:21-34. CrossrefMedlineGoogle Scholar2. HAWKER C. Parathyroid hormone: radioimmunoassay and clinical interpretation. Ann Clin Lab Sci. 1975;5:383-98. MedlineGoogle Scholar3. RIGGSARNAUDREYNOLDSSMITH BCJL. Immunologic differentiation of primary hyperparathyroidism from hyperparathyroidism due to nonparathyroid cancer. J Clin Invest. 1971;50:2079-83. CrossrefMedlineGoogle Scholar4. BENSONRIGGSPICKARDARNAUD RBBC. Radioimmunoassay of parathyroid hormone and hypercalcemic patients with malignant disease. Am J Med. 1974;56:821-6. CrossrefMedlineGoogle Scholar5. BENSONRIGGSPICKARDARNAUD RBBC. Immunoreactive forms of circulating parathyroid hormone in primary and ectopic hyperparathyroidism. J Clin Invest. 1974;54:175-81. CrossrefMedlineGoogle Scholar6. WOOSINGER JF. Radioimmunoassay for human parathyroid hormone. Clin Chim Acta. 1974;54:161-8. CrossrefMedlineGoogle Scholar7. NICHOLSNELSON AJ eds. Radioimmunoassay Manual. San Pedro, California: Nichols Institute; 1977:105-10. Google Scholar8. ORTHNICHOLSONMITCHELL DWW ISLAND DP, LIDDLE GW. Biologic and immunologic characterization and physical separation of ACTH and ACTH fragments in the ectopic ACTH syndrome. J Clin Invest. 1973;52:1756-69. CrossrefMedlineGoogle Scholar9. RAISZMUNDYEILON LGG. Hypercalcemia of neoplastic diseases. In: COPP DH, TALMAGE RV, eds. Endocrinology of Calcium Metabolism. Vancouver: Excerpta Medica; 1977:64-70. Google Scholar10. STEWARTHORSTDEFTOS ARL. A non-PTH renotropic factor in humoral hypercalcemia of malignancy. Clin Res. 1979;27:377A. Abstract. Google Scholar11. RAISZ L. On the diagnosis of primary hyperparathyroidism (or what to do until the immunoassay comes). N Engl J Med. 1971;285:1006-10. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: LAWRENCE G. RAISZ, M.D.; CHAITANYA H. YAJNIK, M.D.; RICHARD S. BOCKMAN, M.D.; BRUCE F. BOWER, M.D.Affiliations: University of Connecticut Health Center Farmington, ConnecticutMemorial Sloan-Kettering Cancer Center New York, New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byRole of Jumpstart Nutrition®, a Dietary Supplement, to Ameliorate Calcium-to-Phosphorus Ratio and Parathyroid Hormone of Patients with OsteoarthritisMetabolism and Measurement of Parathyroid HormoneParathyroid gland anatomical distribution and relation to anthropometric and demographic parameters: a cadaveric studyQuantification of recombinant human parathyroid hormone (rhPTH(1-84)) in human plasma by immunoassay: Commercial kit evaluation and validation to support pharmacokinetic studiesMilk-Alkali Syndrome: A Historical Review and Description of the Modern Version of the SyndromeHypercalcémies extraparathyroïdiennesDésordres du métabolisme du calcium et du phosphate (en dehors de l'insuffisance rénale chronique)Milk-Alkali Syndrome Associated with Calcium Carbonate Consumption: Report of 7 Patients with Parathyroid Hormone Levels and an Estimate of Prevalence Among Patients Hospitalized with HypercalcemiaClinical Problem-Solving: Stopping Short of CertaintyACP Broadsheet no 144: July 1994. The investigation of hypercalcaemia. Association of Clinical Pathologists.Primary Disseminated Form of Ewing Sarcoma in Association with Hypercalcemia and Acute Renal FailureEndocrine Disorders (Parathyroid Hormone)The Measurement of Parathyroid HormoneImmunoassays for parathyroid hormone 1-84 in the diagnosis of hyperparathyroidismStimulation and suppression of intact parathyroid hormone (PTH1–84) in normal subjects and hyperparathyroid patientsHypercalcemia of malignancy: pathophysiology, diagnosis and treatmentDiagnostic applicability of intact and midregion/C-terminal parathyroid hormone assays in calcium metabolic disordersInvited commentaryClinical Application of Intact Parathyroid Hormone DeterminationDetermination of circulating parathyroid hormoneThe pathogenesis of humoral hypercalcaemia of malignancyMeasurement of Parathyroid HormoneLaboratory Diagnosis of Primary HyperparathyroidismPrimary Hyperparathyroidism: A Surgical PerspectiveHYPERCALCEMIA AND SQUAMOUS CELL CARCINOMA COMPLICATING CHRONIC OSTEOMYELITISRenal Osteodystrophy and Maintenance DialysisEndocrine and Metabolic Function in Patients with Neoplastic DiseaseComparison of the performance and clinical utility of a carboxy-terminal assay and an intact assay for parathyroid hormoneClinical and Laboratory Evaluation of a Two-Site Immunoradiometric Assay for Intact Parathyroid HormoneHypercalcemiaImproved differential diagnosis of hypercalcemia by hypocalcemic stimulation of parathyroid hormone secretionTHE VALUE TO THE SURGEON OF PARATHYROID HORMONE ASSAYS IN PRIMARY HYPERPARATHYROIDISMDiagnostic Limitations of Region-Specific Parathyroid Hormone Assays in the Investigation of HypercalcaemiaComparison of Commercially Available Parathyroid Hormone Immunoassays in the Differential Diagnosis of Hypercalcemia: A ReanalysisParathyroid Hormone Radioimmunoassays in the Differential Diagnosis of Hypercalcemia Due to Primary Hyperparathyroidism or MalignancyEDWARD G. LUFKIN, M.D., PAI CHIH KAO, Ph.D., HUNTER HEATH III, M.D.Hypercalcemia in Carcinoma of the Prostate: Case Report and Review of the LiteratureInfluence of serum Ca concentration on circulating molecular forms of PTH in three speciesHypercalcemia in the Critically Ill PatientComparison of Three Parathyroid Hormone AssaysPerformance and Clinical Utility of a Commercially Available 'C-terminal' PTH AssayMid-molecule parathyroid hormone assay comparisonHypoparathyroidismHistomorphometric analysis of osteoclastic bone resorption in metastatic bone disease from various primary malignomasNephrogenous Cyclic AMP, Adenylate Cyclase-Stimulating Activity, and the Humoral Hypercalcemia of MalignancyParathyroid Hormone Radioimmunoassay: The Clinical Evaluation of Assays Using Commercially Available ReagentsHyperparathyroidismAltered divalent ion metabolism in early renal failure: Role of 1,25(OH)2DPancreatic islet cell carcinoma with hypercalcemia. Primary hyperparathyroidism or humoral hypercalcemia of malignancyDetermining the Cause of Hypercalcaemia9 Hormone production by tumours: Biological and clinical aspectsDiagnosis of HyperparathyroidismThe incidence of hypercalcemia in squamous cell carcinoma of the head and neckValue of laboratory tests in the differential diagnosis of hypercalcemiaHyperparathyroidism, Hyperthyroidism, and Cushing's DiseaseComparison of Four Different Carboxylterminal Tracers in a Radioimmunoassay Specific to the 68–84 Region of Human Parathyroid HormoneHypercalcaemia in Cleveland: A Hospital-Based SurveyDo Clinicians Overestimate the Diagnostic Usefulness of Parathyroid Hormone Immunoassays?RadioimmunoassayThe Status of Parathyroid Hormone Measurements in HumansHypocalcemia and HypercalcemiaParathyroid and Calcium DisordersDifferential Laboratory Diagnosis of HypercalcemiaHypercalcemia in head and neck carcinoma incidence and prognosisGranular cell tumor of the bronchus: A previously unreported cause of hypercalcemiaHypercalc�mie bei malignen ErkrankungenHypercalcemia and chest pain in a 48-year-old manUntersuchungen zur Korrelation von Tumorgewicht und typisch pathologischen Laborparametern beim prim�ren und sekund�ren HyperparathyreoidismusDisequilibrium hypercalcaemia.General Principles, Problems, and Interpretation in the Radioimmunoassay of Calcitonin and Parathyroid HormoneHypercalcemia: Long-term follow-up with matched controlsParathyroid HormoneLarge Scale Screening Programme for Selection of Antisera for Radioimmunoassay of Human Parathyroid HormoneThe hypercalcemia of malignancy: Pathogenesis and managementMeasurement of sialyl transferase activity and serum glycoproteins in malignant and benign (hyperparathyroid) hypercalcemiaHypercalcemia in a man with non-Hodgkin's lymphomaA study of prostaglandin E2, parathormone, and response to indomethacin in patients with hypercalcemia of malignancyAsymptomatic hypercalcemia and primary hyperparathyroidismHypercalcaemia of malignancyDifferentiation of hypercalcaemia due to malignancy from primary hyperparathyroidism: The value of parathyroid hormone and plasma bicarbonate measurementsCase 41-1981Calcium regulationRecent advances in parathyroid hormone researchParaneoplastic syndromesThyroid and Parathyroid DiseasesProstaglandins as mediators of paraneoplastic syndromes: Review and up-dateMineral Metabolism in Health and DiseaseMAGNESIUM, CALCIUM, AND PARATHYROID HORMONE INTERACTIONSCimetidine and Parathyroid Hormone LevelsPrimary hyperparathyroidismHypercalcaemia in malignancyPRIMARY HYPERPARATHYROIDISM: CHANGES IN THE PATTERN OF CLINICAL PRESENTATIONParathyroid Hormone RadioimmunoassayJOEL F. HABENER, M.D., GINO V. SEGRE, M.D. 1 November 1979Volume 91, Issue 5Page: 739-740KeywordsAttentionCalciumHypercalcemiaHyperparathyroidismImmunoassaysParathyroid hormoneRenal failure ePublished: 1 December 2008 Issue Published: 1 November 1979 PDF downloadLoading ...