Evaluation of intact serum parathyroid hormone (PTH 1-84) in the diagnosis of disorders of calcium metabolism

Biochemical markers of bone turnover, intact serum parathyroid hormone and renal calcium excretion in patients with pseudohypoparathyroidism and hypoparathyroidism before and during vitamin D treatment

“…Combined with histological evidence of hyperparathyroidism and osteomalacia found in other patients with PHP [1, 3-5, 7, 8, 13, 15], this status resembles renal osteodystrophy. Intact serum PTH, a reliable index of parathyroid hormone secretion [12], was significantly more increased in our patients with PHP than in our patients with I~ This excess PTH was, however, not more active on bone turnover in the patients with PHP, suggesting that bone is substantially resistant in these subjects. Although it cannot be excluded that some patients with PHP may exhibit partial resistance of the bone adenylate cyclase system, there is much evidence that the skeletal changes are mainly acquired resulting from the congenital renal resistance in PHP.…”

“…Intact serum PTH (1-84 PTH) was measured with a two-side immunoradiometric assay ("Allegro Intact PTH") which enabled us to realize parathyroid function in either hyperparathyroidism and hypoparathyroidism [12]. Calcium and creatinine in urine and serum were measured with standard automatic analyser techniques.…”

“…Table 2 summarizes the laboratory data for classification of the patients. The subjects with HP presented with hypocalcaemia, hyperphosphataemia and low or undetectable concentrations of PTH, measured with an antibody detecting the midregion of the hormone [12]. Synthetic PTH fragment 1-38 [11] was administered intravenously at a dose of 0.5 gg/kg body weight to one-third of the patients and produced normal increments of urinary and plasma cAMP.…”