Hyperparathyroidism laboratory findings: Difference between revisions
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===Alkaline Phosphatase=== | ===Alkaline Phosphatase=== | ||
[[Alkaline phosphatase]] levels are elevated in all types of hyperparathyroidism. | [[Alkaline phosphatase]] levels are elevated in all types of hyperparathyroidism. | ||
==Diagnosis== | |||
The gold standard of diagnosis is the PTH immunoassay. Once an elevated PTH has been confirmed, goal of diagnosis is to determine whether the hyperparathyroidism is primary or secondary in origin by obtaining a serum [[calcium]] level: | |||
{| class="wikitable" | |||
| '''PTH''' || '''serum [[calcium]]''' || '''likely type''' | |||
|- | |||
| high || high || [[primary hyperparathyroidism]] | |||
|- | |||
| high || low or normal || [[secondary hyperparathyroidism]] | |||
|} | |||
[[Tertiary hyperparathyroidism]] has a high PTH and a high serum calcium. It is differentiated from primary hyperparathyroidism by a history of [[chronic kidney failure]] and [[secondary hyperparathyroidism]]. | |||
==References== | ==References== | ||
Revision as of 14:06, 20 September 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Laboratory Findings
Serum Calcium
In cases of primary, tertiary and quintary hyperparathyroidism increased PTH consequently leads to increased serum calcium (hypercalcemia) due to:
- increased bone resorption, allowing flow of calcium from bone to blood
- reduced renal clearance of calcium
- increased intestinal calcium absorption
By contrast, in secondary and quartary hyperparathyroidism effectiveness of PTHis reduced.
Serum Phosphorus
In primary hyperparathyroidism, serum phosphorus levels are abnormally low as a result of decreased renal tubular phosphorus reabsorption. This contrasts with secondary hyperparathyroidism, in which serum phosphorus levels are generally elevated because of renal disease.
Alkaline Phosphatase
Alkaline phosphatase levels are elevated in all types of hyperparathyroidism.
Diagnosis
The gold standard of diagnosis is the PTH immunoassay. Once an elevated PTH has been confirmed, goal of diagnosis is to determine whether the hyperparathyroidism is primary or secondary in origin by obtaining a serum calcium level:
| PTH | serum calcium | likely type |
| high | high | primary hyperparathyroidism |
| high | low or normal | secondary hyperparathyroidism |
Tertiary hyperparathyroidism has a high PTH and a high serum calcium. It is differentiated from primary hyperparathyroidism by a history of chronic kidney failure and secondary hyperparathyroidism.