Biochemical diagnosis of primary hyperparathyroidism: Analysis of the sensitivity of total and ionized calcium in combination with PTH.

Erik Nordenström, Per Katzman, Anders Bergenfelz

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26 Citations (SciVal)

Abstract

OBJECTIVES: To investigate the accuracy of the biochemical diagnosis of primary hyperparathyroidism (pHPT) in a consecutive series of patients with operatively verified disease. DESIGN AND SUBJECTS: Four hundred thirty-six patients with pHPT, 340 women and 96 men, were reviewed. Biochemical variables, including total calcium (Ca), ionized calcium (Cai) and PTH were analyzed and registered in a prospective database. RESULTS: In the subgroup of patients with more mild hypercalcemia (Ca below 2.70mmol/L) the correlation between Ca and Cai was poor. 19 respectively 18 patients had preoperatively a Ca respectively Cai level within the reference range. Further 35 patients had preoperatively a normal level of PTH. The diagnostic sensitivities for Ca, Cai and the combination of Ca and Cai were 96%, 96% and 99%. CONCLUSION: If calcium and ionized calcium are not used in the diagnostic workup of pHPT some 4% of the patients will be overlooked. We recommend analyzing both Ca and Cai in the diagnostic workup of pHPT.
Original languageEnglish
Pages (from-to)849-852
JournalClinical Biochemistry
Volume44
DOIs
Publication statusPublished - 2011

Subject classification (UKÄ)

  • Biochemistry and Molecular Biology

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