Hyperparathyroidism laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].

OR

Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

OR

[Test] is usually normal among patients with [disease name].

OR

Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].

OR

There are no diagnostic laboratory findings associated with [disease name].

Laboratory Findings

Primary hyperparathyroidism

• An elevated serum ionized calcium on routine biochemical screening in a asymptomatic patient should raise the suspicion of primary hyperparathyroidism.
• An elevated/ concentration of serum ionized calcium with elevated parathyroid level is diagnostic of primary hyperparathyoidism.
• Laboratory findings consistent with the diagnosis of primary hyperparathyroidism include
  • Elevated/ concentration of serum ionized calcium
  • Elevated parathyroid level

• Some patients with primary hyperparathyroidism may have elevated concentration of serum parathyroid hormone with normal serum ionized calcium, which is usually suggestive of normocalcemic primary hyperparathyroidism. Causes of secondary hyperparathyroidism should be rules out for making the diagnosis of normocalcemic primary hyperparathyroidism. Normocalcemic primary hyperparathyroidism might represent the first symptomatic stage of primary hyperparathyroidism.

Secondary hyperparathyroidism

• Laboratory findings consistent with the diagnosis of secondary hyperparathyroidism include:
  • Elevated serum parathyroid hormone level
  • Low to normal serum ionized calcium
  • Low serum vitamin D (25-hydroxy vitamin D) may be found if vitamin D deficiency is the cause of secondary hyperparathyroidism.

Tertiary hyperparathyroidism

• An elevated concentration of serum ionized calcium with elevated parathyroid level in post renal transplant patients is diagnostic of tertiary hyperparathyoidism.