A RADIOIMMUNOASSAY FOR PARATHYROID HORMONE IN MAN

1970 ◽  
Vol 63 (4) ◽  
pp. 655-666 ◽  
Author(s):  
R. M. Lequin ◽  
W. H. L. Hackeng ◽  
W. Schopman
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Guinea Pig ◽  
Secondary Hyperparathyroidism ◽  
Calcium Metabolism ◽  
Normal Adult ◽  
Normal Range ◽  
The Mean

ABSTRACT With a guinea-pig antiserum against bovine PTH, human PTH could be measured in plasma. PTH-levels were expressed in terms of equivalents b/PTH per ml. In normal, adult subjects the mean plasma PTH concentration was 140 pg b-PTH eq./ml with a range of non-detectable (< 70) to 200 pg b-PTH eq./ml. Patients with primary hyperparathyroidism showed overlap with the normal range; in secondary hyperparathyroidism the levels were usually far higher. The PTH levels in patients with a variety of disorders involving calcium metabolism were studied.

PARATHYROID HORMONE SECRETION IN DISORDERS OF CALCIUM METABOLISM STUDIED BY MEANS OF EDTA

1974 ◽  
Vol 75 (2) ◽  
pp. 286-296 ◽  
Author(s):  
J. H. Lockefeer ◽  
W. H. L. Hackeng ◽  
J. C. Birkenhäger
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Calcium Metabolism ◽  
Hormone Secretion ◽  
Parathyroid Tissue ◽  
Small Mass ◽  
Idiopathic Hypercalciuria ◽  
List Type ◽  
Immunoreactive Parathyroid Hormone ◽  
Pth Level

ABSTRACT In 22 of 28 cases of primary hyperparathyroidism (PHP) the rise in the serum immunoreactive parathyroid hormone (IRPTH or PTH) level observed in response to lowering of the serum calcium by EDTA, exceeded that obtained in 8 control subjects. In 5 of these 22 patients who were studied again after parathyroidectomy the supranormal response was abolished. Fifteen of these 22 hyper-responsive PHP patients had basal IRPTH levels not exceeding the highest level in the controls and that of other groups of patients investigated (idiopathic hypercalciuria, non-parathyroid hypercalcaemia, operated PHP). Fourteen of the 22 hyper-reactive patients with PHP did not show hypocalcaemia during the infusion of EDTA. The extent of the release of PTH elicited by EDTA in cases of PHP does not as yet allow a prediction of the amount of pathological parathyroid tissue present, although all the PHP patients showing a normal release of PTH had a relatively small mass of parathyroid tissue (up to about 1 g) subsequently removed. In 9 cases of nephrolithiasis (8 of whom had idiopathic hypercalciuria) and in 7 cases of non-parathyroid hypercalcaemia, a normal PTH release was found.

A radioimmunoassay for human parathyroid hormone utilizing a goat anti-bovine PTH serum

1981 ◽  
Vol 96 (2) ◽  
pp. 215-221 ◽  
Author(s):  
L. E. Mallette
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Secondary Hyperparathyroidism ◽  
Human Serum ◽  
Central Region ◽  
Antigenic Site ◽  
Human Parathyroid Hormone ◽  
Domestic Goat ◽  
Standard Serum ◽  
Dilution Curves

Abstract. An antiserum (NG-1) against bovine PTH (bPTH) generated in the domestic goat was characterized for use in the radioimmunoassay of PTH in human serum. When a carboxyterminal fragment of bPTH is used as radioligand, this antiserum detects only an antigenic site in the central region of the hPTH molecule. The synthetic hormone fragment, hPTH-(44-68), will displace 93% of the tracer, after which the addition of intact hPTH causes no further displacement. The assay does not detect the synthetic aminoterminal 1-34 fragment of the bovine or human hormones, nor the carboxyterminal fragment of the human hormone, hPTh-(53-84). Standard curves with bPTH-(1-84) and partially purified hPTH are not parallel, so that hPTH is used as standard. Serum from subjects with uraemia or primary hyperparathyroidism gives dilution curves parallel to that with the hPTH standard. The assay with NG-1 has been applied to the diagnosis of primary and secondary hyperparathyroidism, used to monitor the disappearance of PTH after parathyroidectomy, and for measurement of PTH in selective venous samples.

scholarly journals Relationship between parathyroid calcium-sensing receptor expression and potency of the calcimimetic, cinacalcet, in suppressing parathyroid hormone secretion in an in vivo murine model of primary hyperparathyroidism

2005 ◽  
Vol 153 (4) ◽  
pp. 587-594 ◽  
Author(s):  
Takehisa Kawata ◽  
Yasuo Imanishi ◽  
Keisuke Kobayashi ◽  
Takao Kenko ◽  
Michihito Wada ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Secondary Hyperparathyroidism ◽  
Murine Model ◽  
Hormone Secretion ◽  
Suppressive Effect ◽  
Receptor Expression ◽  
Parathyroid Glands ◽  
Calcium Sensing Receptor ◽  
Calcium Sensing

Cinacalcet HCl, an allosteric modulator of the calcium-sensing receptor (CaR), has recently been approved for the treatment of secondary hyperparathyroidism in patients with chronic kidney disease on dialysis, due to its suppressive effect on parathyroid hormone (PTH) secretion. Although cinacalcet’s effects in patients with primary and secondary hyperparathyroidism have been reported, the crucial relationship between the effect of calcimimetics and CaR expression on the parathyroid glands requires better understanding. To investigate its suppressive effect on PTH secretion in primary hyperparathyroidism, in which hypercalcemia may already have stimulated considerable CaR activity, we investigated the effect of cinacalcet HCl on PTH-cyclin D1 transgenic mice (PC2 mice), a model of primary hyperparathyroidism with hypo-expression of CaR on their parathyroid glands. A single administration of 30 mg/kg body weight (BW) of cinacalcet HCl significantly suppressed serum calcium (Ca) levels 2 h after administration in 65- to 85-week-old PC2 mice with chronic biochemical hyperparathyroidism. The percentage reduction in serum PTH was significantly correlated with CaR hypo-expression in the parathyroid glands. In older PC2 mice (93–99 weeks old) with advanced hyperparathyroidism, serum Ca and PTH levels were not suppressed by 30 mg cinacalcet HCl/kg. However, serum Ca and PTH levels were significantly suppressed by 100 mg/kg of cinacalcet HCl, suggesting that higher doses of this compound could overcome severe hyperparathyroidism. To conclude, cinacalcet HCl demonstrated potency in a murine model of primary hyperparathyroidism in spite of any presumed endogenous CaR activation by hypercalcemia and hypo-expression of CaR in the parathyroid glands.

scholarly journals Potential Clinical Utility of a New IRMA for Parathyroid Hormone in Postmenopausal Patients with Primary Hyperparathyroidism

2004 ◽  
Vol 50 (3) ◽  
pp. 626-631 ◽  
Author(s):  
Vincenzo Carnevale ◽  
Simona Dionisi ◽  
Italo Nofroni ◽  
Elisabetta Romagnoli ◽  
Federica Paglia ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Clinical Utility ◽  
Second Generation ◽  
Control Group ◽  
Roc Curve Analysis ◽  
Potential Clinical Utility ◽  
The Mean ◽  
Serum Pth ◽  
First And Second Generation

Abstract Background: A new commercially available (so-called second-generation) IRMA for parathyroid hormone (PTH) separately detects intact PTH and its N-truncated fragments; however, no studies have compared the first- and second-generation IRMAs for PTH in patients with primary hyperparathyroidism (PHPT) to assess their respective diagnostic accuracies. Methods: We concomitantly investigated 39 postmenopausal patients with PHPT and a control group of 70 healthy postmenopausal women matched for age, renal function, and vitamin D status. In all individuals, PTH was measured with a classic IRMA (PTH-S; DiaSorin Inc.), which uses antibodies directed against epitopes 1–34 and 39–84, and a new method (Scantibodies Laboratory. Inc.), which uses antibodies against epitopes 1–4 and 39–84 (PTH-W) and epitopes 7–34 and 39–84 (PTH-T). We also assayed serum PTH in 10 PHPT patients every 24 h for 5 days after successful surgery. Results: The different assays gave serum PTH values that were &gt;2 SD higher than values for the control population in 59% (PTH-S), 77% (PTH-W), and 82% (PTH-T) of patients with PHPT. However, ROC curve analysis showed no significant differences among the three PTH assays, demonstrating overlapping diagnostic sensitivities. In PHPT patients, the correlation among the assays was highly significant (r = 0.91–0.92; P &lt;0.001). The ratio PTH-W:PTH-T × 100 showed a gaussian distribution in both PHPT patients and controls, whose mean (SD) values [63.4 (13.3)% vs 64.5 (9.5)%, respectively] did not differ significantly. After parathyroidectomy, the mean percentages of variation in PTH detected with all of the assays were quite similar. Conclusions: The distribution of the PTH-W:PTH-T ratio in patients and controls suggests that PHPT does not markedly influence the rate at which biologically inactive fragments are generated by central or peripheral cleavage of PTH. The similar postoperative curves seem to contradict the hypothesized effect of acute hypocalcemia in modulating the central secretion of hormonal fragments. Our results indicate that the three investigated assays have similar diagnostic sensitivities in PHPT.

scholarly journals Serum 25(OH)D Level and Parathyroid Hormone in Chinese Adult Population: A Cross-Sectional Study in Guiyang Urban Community from Southeast of China

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Zhang Qiao ◽  
Shi Li-xing ◽  
Peng Nian-chun ◽  
Xu Shu-jing ◽  
Zhang Miao ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Secondary Hyperparathyroidism ◽  
Adult Population ◽  
Cross Sectional Study ◽  
Vitamin D Insufficiency ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
The Mean ◽  
Serum Pth

Objective. To evaluate vitamin D status and serum parathyroid hormone (IPTH) of healthy adults living in Guiyang.Design and Participants. We conducted a cross-sectional evaluation in the General Community in Guiyang by cluster sampling method. The data was a part of 1510 participants (634 men, 876 women) aged 20–79 years median 45.2 years from November 2009 to February 2010 in Guiyang Health Measures Survey.Measurements. Aradioimmunoassay was used to measure the level of 25-hydroxyvitamin D [25(OH)D] and intact parathyroid hormone (iPTH).Results.The mean serum 25(OH)D level was (20.4 ± 9.0) ng/mL and the highest level among participants aged 40–59 years (22.8 ng/mL). The mean serum PTH level was (32.1 ± 13.7) pg/mL and the lowest level among participants aged 40–50 years (30.8 ng/mL). Serum 25(OH)D was below 50 nmol/liter in 52.3%, below 75 nmol/liter in 84.6%, and above 75 nmol/liter in 15.4% of the respondents. Secondary hyperparathyroidism was 5.4% (5.4% among men and 4.6% among women). The prevalence of secondary hyperparathyroidism increased (5.8%, 6.5%, and 7.1%, resp.) with decreasing serum 25(OH)D levels among subjects who were 30 to 20, 19.9 to 10, and <10 ng/mL, respectively. Serum 25(OH)D was inversely associated with serum PTH.Conclusions. Vitamin D insufficiency and its complication of secondary hyperparathyroidism are common.

Concomitant Graves’ disease and primary hyperparathyroidism: clinical implications and preoperative localization of parathyroid adenoma by fine needle biopsy

Open Medicine ◽  
2006 ◽  
Vol 1 (3) ◽  
pp. 298-305
Author(s):  
Michael Thalhammer ◽  
Amra Cuk ◽  
Heinz Pitzl ◽  
Klaus-Dieter Palitzsch
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Hormone Level ◽  
Needle Aspiration ◽  
Graves Disease ◽  
Parathyroid Hormone Level ◽  
Normal Range ◽  
Fine Needle

AbstractA 53-year old female patient, who presented with retrosternal pain, which could be ascribed to reflux oesophagitis and gastritis, furthermore stated recurrent palpitations, sweating and the feeling of uneasiness. In routine laboratory investigation hyperthyroidism and hypercalcaemia were detected. Further testing revealed elevated TSH receptor antibodies and a parathyroid hormone level within the normal range. Scintigraphically a homogeneous, but increased uptake was found. In ultrasonography guided fine needle aspiration biopsy of a nodule parathyroid hormone was verifiable by immunochemical means.Under thyrostatic treatment with carbimazole the patient became euthyroid, simultaneous a decrease of serum calcium levels could be observed. Parathyroid hormone level remained in normal range. After confirmation of Graves’ disease and adenoma of the parathyroid gland parathyroidectomy in combination with near total resection of the thyroid gland was performed. In conclusions concomitant Graves’ disease and primary hyperparathyroidism is rare, but should be considered in case of persisting hypercalcaemia after the patient became euthyroid again, when parathyroid hormone level is in normal range or elevated. Thus a potentially required second operation can be avoided. By ultrasonography guided fine needle aspiration biopsy and immunochemical processing adenomas of parathyroid glands can be localized preoperatively.

scholarly journals Factors associated with parathyroid hormone control in haemodialysis patients with secondary hyperparathyroidism treated with cinacalcet in real-world clinical practice: Mimosa study

2019 ◽  
Vol 12 (6) ◽  
pp. 871-879 ◽  
Author(s):  
Jacques Rottembourg ◽  
Pablo Ureña-Torres ◽  
Daniel Toledano ◽  
Victor Gueutin ◽  
Abdelaziz Hamani ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Secondary Hyperparathyroidism ◽  
Real Life ◽  
Normal Range ◽  
Life Study ◽  
Dialysis Vintage ◽  
Cinacalcet Hydrochloride ◽  
Kdigo Guidelines ◽  
Hormone Control

Abstract Background Secondary hyperparathyroidism (SHPT) is frequent in haemodialysis (HD) patients. Oral cinacalcet-hydrochloride (HCl) decreases parathyroid hormone (PTH); however, real-life PTH data, according to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, are still lacking. Our goal is to assess the percentage of cinacalcet-HCl-treated HD patients with controlled SHPT (PTH &lt;9× upper limit of the normal range) after 12 months (M12) of treatment. Methods This is a retrospective observational study in HD patients with SHPT treated by cinacalcet-HCl between 2005 and 2015 and dialysed in seven French HD centres using the same database (Hemodial™). Results The study included 1268 patients with a mean (standard deviation) follow-up of 21 ± 12 months. Their mean dialysis vintage was 4.3 ± 5.6 years. PTH values were available and exploitable at M12 in 50% of them (645 patients). Among these patients, 58.9% had controlled (mean PTH of 304 ± 158 pg/mL) and 41.1% uncontrolled SHPT (mean PTH of 1084 ± 543) at M12. At the baseline, patients with controlled SHPT were older (66 ± 15 versus 61 ± 17 years), and had lower PTH (831 ± 346 versus 1057 ± 480 pg/mL) and calcaemia (2.18 ± 0.2 versus 2.22 ± 0.19 mmol/L) than uncontrolled patients. In multivariate analysis, these three factors still remained significantly associated with controlled SHPT. Conclusion In this real-life study, 41.1% of HD patients with SHPT treated with cinacalcet-HCl remained with a PTH above the KDIGO recommended target after 12 months of treatment. Apart from the possibility of non-compliance, the severity of SHPT appears to be a major factor determining the response to cinacalcet-HCl treatment, reinforcing the importance of treating SHPT at earlier stages.

scholarly journals Clinical impact of two different intraoperative parathyroid hormone assays in primary and renal hyperparathyroidism

2009 ◽  
Vol 160 (2) ◽  
pp. 275-281 ◽  
Author(s):  
Sonja-Kerstin Meyer ◽  
Markus Zorn ◽  
Karin Frank-Raue ◽  
Markus W Büchler ◽  
Peter Nawroth ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Clinical Impact ◽  
Renal Hyperparathyroidism ◽  
Normal Range ◽  
Persistent Disease ◽  
Intraoperative Pth ◽  
Intraoperative Parathyroid Hormone

BackgroundIntraoperative parathyroid hormone (PTH) monitoring predicts successful surgery for primary hyperparathyroidism (pHPT). In renal HPT, intraoperative PTH assays can define whether parathyroid resection is adequate.MethodsIntraoperative PTH was measured with two different immunometric assays (Immulite Turbo DPC and ADVIA Centaur assay) in 91 patients undergoing parathyroidectomy for primary (n=57) and renal (n=34) hyperparathyroidism. PTH was monitored preoperatively, 10, 20, and 30 min after parathyroidectomy and 24 h postoperatively.ResultsTen minutes after parathyroidectomy, intraoperative PTH dropped into the normal range (<7.6 pmol/l) in 84% of patients with pHPT and tertiary HPT as measured with the ADVIA Centaur assay (PTH-A), compared with 100% of the samples measured with the Immulite Turbo DPC assay (PTH-I; P=0.0082). Twenty minutes after parathyroidectomy for secondary HPT, intraoperative PTH decreased to the normal range in 100% measured with PTH-I compared with 50% measured with PTH-A (P=0.009). Then, 24 h postoperatively, PTH-I and PTH-A levels were within the normal range in all of the successfully treated patients. Both assays correctly identified six patients with persistent disease and another patient with a double adenoma in pHPT.ConclusionsIn patients undergoing parathyroidectomy for primary or renal HPT, PTH levels decreasing to the normal range indicated successful surgery in all of the patients as measured with the PTH-I assay. Comparing the two assays, PTH-I was able to quantify the intraoperative PTH decay more quickly than PTH-A.

The Parathyroids

2017 ◽  
Author(s):  
Courtney J. Balentine ◽  
C Taylor Geraldson
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Secondary Hyperparathyroidism ◽  
Calcium Homeostasis ◽  
Multiple Endocrine Neoplasia ◽  
Laryngeal Nerve ◽  
Parathyroid Glands ◽  
Tertiary Hyperparathyroidism ◽  
Endocrine Neoplasia ◽  
And Function

Successful surgery of the parathyroid glands depends on a thorough knowledge of their anatomic and developmental relations. This knowledge is crucial for locating ectopic parathyroids or preventing injury to the recurrent laryngeal nerve. In addition, the surgeon should understand the physiology and function of these glands. Unlike other conditions a surgeon might treat, physiology, and not anatomy alone, often dictates the timing and course of parathyroid procedures. This surgeon-oriented, focused review covers the development, histology, anatomy, physiology, and pathophysiology of the parathyroid. Figures show the location and frequencies of ectopic upper and lower parathyroid glands, and regulation of calcium homeostasis. This review contains 2 highly rendered figures, and 16 references Key words: calcitonin; hypercalcemia; hyperparathyroidism; multiple endocrine neoplasia; parathyroid; parathyroid hormone; primary hyperparathyroidism; secondary hyperparathyroidism; tertiary hyperparathyroidism

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