Scandinavian Journal of Clinical and Laboratory Investigation
ISSN: 0036-5513 (Print) 1502-7686 (Online) Journal homepage: http://www.tandfonline.com/loi/iclb20
Primary hyperparathyroidism or hypercalcaemia of malignancy? K. I. Birkeland, F. Gallefoss, S. Olsson & E. Haug To cite this article: K. I. Birkeland, F. Gallefoss, S. Olsson & E. Haug (1992) Primary hyperparathyroidism or hypercalcaemia of malignancy?, Scandinavian Journal of Clinical and Laboratory Investigation, 52:4, 347-349, DOI: 10.1080/00365519209088368 To link to this article: http://dx.doi.org/10.1080/00365519209088368
Published online: 29 Mar 2011.
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Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=iclb20 Download by: [University of Saskatchewan Library]
Date: 31 March 2016, At: 15:17
Scand J Clin Lab Invest 1992; 52: 347-349
Primary hyperparathyroidism or hypercalcaemia of malignancy? K . I . B I R K E L A N D , F. G A L L E F O S S , " S . O L S S O N * & E . H A U G
Downloaded by [University of Saskatchewan Library] at 15:17 31 March 2016
Hormone Laboratory, Aker Hospital, Oslo, and :':Department of Internal Medicine, Central Hospital of Vest-Agder, Kristiansand, Norway
Birkeland KI, Gallefoss F, Olsson S, Haug E. Primary hyperparathyroidism or hypercalcaemia of malignancy? Scand J Clin Lab Invest 1992; 52: 347-349. The introduction of two-site immunometric assays measuring intact parathyroid hormone (PTH) and radioimmunoassays measuring PTH-related peptide (FTHRP) have simplified the evaluation of patients with hypercalcaemia. We present a 63-year-old man with recurrent hypercalcaemia after surgical treatment for primary hyperparathyroidism 3 years previously. PTH measured with a midregion radioimmunoassay gave normal values, at the same level as during his primary hyperparathyroidism. Intact PTH was, however, clearly suppressed, and he had a highly elevated level of PTH-RP. This suggested that he had humoral hypercalcaemia of malignancy. The patient died after 2 months, and at autopsy an adenocarcinoma of the pancreas with no skeletal metastases was found.
Key words: intact parathyroid hormone (PTH) and PTH-related peptide (PTH-RP) K4re I. Birkeland, Hormone Laboratory, Aker Hospital, 0514 Oslo 5 , Norway
Hypercalcaemia is a common condition, the prevalence being about 1% in a genera1 Scandinavian population [1]. In more than 90% of hypercalcaemic patients the cause is primary hyperparathyroidism or malignant disease [2]. The evaluation of parathyroid function has been facilitated by the introduction of immunometric assays measuring intact parathyroid hormone (PTH). These assays have greatly increased sensitivity and specificity compared with the previously widely used mid region PTH radio-immunoassays [3]. In this report we discuss hypercalcaemia in a 63-year-old man previously surgically treated for primary hyperparathyroidism. This case demonstrates the advantage of an assay measuring intact PTH compared to a midregion assay, and also suggests a role for
measurements of PTH-related peptide (PTHRP) in the evaluation of hypercalcaemic patients.
METHODS Serum concentrations of calcium (2.20-2.60 mmol I-') and phosphate (0.45-1.55 mmol I-') were measured using routine methods, with inter-assay coefficients of variation
ISSN: 0036-5513 (Print) 1502-7686 (Online) Journal homepage: http://www.tandfonline.com/loi/iclb20
Primary hyperparathyroidism or hypercalcaemia of malignancy? K. I. Birkeland, F. Gallefoss, S. Olsson & E. Haug To cite this article: K. I. Birkeland, F. Gallefoss, S. Olsson & E. Haug (1992) Primary hyperparathyroidism or hypercalcaemia of malignancy?, Scandinavian Journal of Clinical and Laboratory Investigation, 52:4, 347-349, DOI: 10.1080/00365519209088368 To link to this article: http://dx.doi.org/10.1080/00365519209088368
Published online: 29 Mar 2011.
Submit your article to this journal
Article views: 3
View related articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=iclb20 Download by: [University of Saskatchewan Library]
Date: 31 March 2016, At: 15:17
Scand J Clin Lab Invest 1992; 52: 347-349
Primary hyperparathyroidism or hypercalcaemia of malignancy? K . I . B I R K E L A N D , F. G A L L E F O S S , " S . O L S S O N * & E . H A U G
Downloaded by [University of Saskatchewan Library] at 15:17 31 March 2016
Hormone Laboratory, Aker Hospital, Oslo, and :':Department of Internal Medicine, Central Hospital of Vest-Agder, Kristiansand, Norway
Birkeland KI, Gallefoss F, Olsson S, Haug E. Primary hyperparathyroidism or hypercalcaemia of malignancy? Scand J Clin Lab Invest 1992; 52: 347-349. The introduction of two-site immunometric assays measuring intact parathyroid hormone (PTH) and radioimmunoassays measuring PTH-related peptide (FTHRP) have simplified the evaluation of patients with hypercalcaemia. We present a 63-year-old man with recurrent hypercalcaemia after surgical treatment for primary hyperparathyroidism 3 years previously. PTH measured with a midregion radioimmunoassay gave normal values, at the same level as during his primary hyperparathyroidism. Intact PTH was, however, clearly suppressed, and he had a highly elevated level of PTH-RP. This suggested that he had humoral hypercalcaemia of malignancy. The patient died after 2 months, and at autopsy an adenocarcinoma of the pancreas with no skeletal metastases was found.
Key words: intact parathyroid hormone (PTH) and PTH-related peptide (PTH-RP) K4re I. Birkeland, Hormone Laboratory, Aker Hospital, 0514 Oslo 5 , Norway
Hypercalcaemia is a common condition, the prevalence being about 1% in a genera1 Scandinavian population [1]. In more than 90% of hypercalcaemic patients the cause is primary hyperparathyroidism or malignant disease [2]. The evaluation of parathyroid function has been facilitated by the introduction of immunometric assays measuring intact parathyroid hormone (PTH). These assays have greatly increased sensitivity and specificity compared with the previously widely used mid region PTH radio-immunoassays [3]. In this report we discuss hypercalcaemia in a 63-year-old man previously surgically treated for primary hyperparathyroidism. This case demonstrates the advantage of an assay measuring intact PTH compared to a midregion assay, and also suggests a role for
measurements of PTH-related peptide (PTHRP) in the evaluation of hypercalcaemic patients.
METHODS Serum concentrations of calcium (2.20-2.60 mmol I-') and phosphate (0.45-1.55 mmol I-') were measured using routine methods, with inter-assay coefficients of variation
