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Clinical Chemistry 0: clinchem.2005.060962v1, 2006; 10.1373/clinchem.2005.060962
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Received on ,
Accepted on ,

Technical Briefs

Unexpected Serum Parathyroid Hormone Profiles in Some Patients with Primary Hyperparathyroidism

Philippe Boudou 1*, Fidaa Ibrahim 2, Catherine Cormier 3, Emile Sarfati 4, Jean-Claude Souberbielle 5

1 Department of Hormonal Biology, Hôpital Saint-Louis, Paris, France, and INSERM U 671, Paris, France
2 Department of Hormonal Biology, Hôpital Saint-Louis, Paris, France
3 Department of Rhumatologie, Hôpital Cochin, Paris, France
4 Department of Endocrine Surgery, Hôpital Saint-Louis, Paris, France
5 Physiology Laboratory, Hôpital Necker-Enfants Malades, Assistance Publique, Hôpitaux de Paris, Paris, France

* To whom correspondence should be addressed. E-mail: philippe.boudou{at}sls.aphp.fr.

Background: Third-generation parathyroid hormone (PTH) assays have been reported to measure only intact PTH(1-84), in contrast to second-generation assays, which also detect PTH(7-84) fragments. We obtained higher PTH measurements with third- than with second-generation PTH assays in patients with either severe primary hyperparathyroidism or parathyroid carcinoma.

Methods: We analyzed biological data [second- and third-generation PTH assays, 25-hydroxyvitamin D (25-OHD), calcium, and phosphate concentrations] obtained before and after surgery for 2 groups of patients selected from a large series of consecutive patients with primary hyperparathyroidism (PHPT): 7 female patients with surgically and histologically confirmed PHPT (group 1) and a matched group (group 2).

Results: For group 1 but not group 2, PTH concentrations measured by third-generation PTH assays before surgery were higher than those measured by the second-generation assays. Circulating 25-OHD, calcium, and phosphate concentrations were similar in both groups. In addition, PTH values measured with the third-generation PTH assays in group 1 decreased after surgery.

Conclusions: Our results confirm that third-generation PTH assays do not measure only PTH(1-84). The frequency of this unexpected finding of markedly lower PTH concentrations than previously reported was ~5% in patients with PHPT without malignancy. We do not know whether the presence of this unexpected profile is predictive of malignancy.


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Home page
 Clin. Chem.Home page
M. R. Rubin, S. J. Silverberg, P. D'Amour, J.-H. Brossard, L. Rousseau, J. Sliney Jr, T. Cantor, and J. P. Bilezikian
An N-Terminal Molecular Form of Parathyroid Hormone (PTH) Distinct from hPTH(1 84) Is Overproduced in Parathyroid Carcinoma
Clin. Chem., August 1, 2007; 53(8): 1470 - 1476.
[Abstract] [Full Text] [PDF]


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