Parathyroid adenoma laboratory findings

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

Laboratory Findings

• An elevated serum calcium on routine biochemical screening in a asymptomatic patient should raise the suspicion of parathyroid adenoma.
• An elevated concentration of serum calcium with elevated parathyroid hormone level is diagnostic of primary hyperparathyroidism. Majority of times, increase in secretion of parathyroid hormone is the result of parathyroid adenoma (85%).
• 25-Hydroxy vitamin D is usually normal among patients with primary hyperparathyroidism.
• Laboratory findings consistent with the diagnosis of primary hyperparathyroidism include:
  • Elevated concentration of serum calcium
  • Elevated serum parathyroid hormone level
  • Low normal serum phosphate concentration
  • Elevated 1,25-dihydroxy vitamin D (calcitriol) may be found in around half of patients.
  • There is a mild elevation in bone turnover indices including serum alkaline phosphatase activity, osteocalcin, and urinary hydroxypiridinium collagen crosslinks.