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DYNAMIC TESTS OF PARATHYROID FUNCTION FOR DIAGNOSIS OF PRIMARY HYPERPARATHYROIDISM IN MALIGNANCY
Author(s) -
LJUNGHALL S.,
BENSON L.,
RASTAD J.,
WIDE L,
AKERSTROM G.
Publication year - 1987
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1987.tb01141.x
Subject(s) - hypercalcaemia , primary hyperparathyroidism , malignancy , medicine , endocrinology , parathyroid hormone , calcitonin , pseudohypoparathyroidism , hyperparathyroidism , calcium
SUMMARY Hypercalcaemia can be caused by malignant diseases as well as by primary hyperparathyroidism (HPT). The two disorders may occur together and an accurate discrimination between them is sometimes not possible from basal measurements of calcium and parathyroid hormone (PTH) concentrations. In primary HPT the regulation of PTH secretion is maintained, albeit the set‐point is shifted to a hypercalcaemic value. Therefore, when serum calcium is lowered by ethylene diamine tetra‐acetic acid (EDTA) infusions or calcitonin injections, patients with primary HPT display enhanced secretion of PTH already within the hypercalcaemic range, whereas parathyroid function remains suppressed in malignancy‐associated hypercalcaemia. Tests based on this principle enable a specific identification of HPT. The present report describes eight hypercalcaemic patients with disseminated malignancy where HPT could be diagnosed by the use of such stimulatory tests.