Clinical Chemistry
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Clinical Chemistry 34: 2439-2443, 1988;
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Clinical Chemistry, Vol 34, 2439-2443, Copyright © 1988 by American Association for Clinical Chemistry

Clinical performance of a parathyrin immunoassay with dynamically determined reference values

R Lepage, P D'Amour, A Boucher, L Hamel, C Demontigny and F Labelle
Centre de recherche clinique Andre-Viallet, Universite de Montreal, Quebec, Canada.

We compared the clinical performance of a carboxyl-terminal radioimmunoassay for human parathyroid hormone (iPTH), using either a dynamic reference interval (95% confidence limits of serum iPTH concentrations observed in 11 normal individuals during intravenous infusions of Na2EDTA and CaCl2) or a gaussian (2 SD) reference interval derived from 233 normocalcemic individuals. The 2 SD ranges were 3.5 to 9.8 pmol/L for serum iPTH and 2.19 to 2.53 mmol/L for total calcium. The iPTH dynamic interval was lower for calcium concentrations greater than 2.50 mmol/L; it was higher, wider, and continued to increase for calcium values less than or equal to 2.25 mmol/L. Use of the dynamic reference interval increased the clinical sensitivity of our assay from 81% and 61% to 100%, respectively, in primary hyperparathyroidism (n = 47) and hypoparathyroidism (n = 18). Test specificity was maintained at 100% in hypocalcemic disorders but fell to 93% (62/67) in hypercalcemic disorders. Overall, use of the dynamic reference interval improved the assay performance.


The following articles in journals at HighWire Press have cited this article:


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L. M. Henrich, A. D. Rogol, P. D'Amour, M. A. Levine, J. B. Hanks, and D. E. Bruns
Persistent Hypercalcemia After Parathyroidectomy in an Adolescent and Effect of Treatment With Cinacalcet HCl
Clin. Chem., December 1, 2006; 52(12): 2286 - 2293.
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Copyright © 1988 by the American Association for Clinical Chemistry.