Document Detail


Parathyroid hormone and parathyroid hormone related protein assays in the investigation of hypercalcemic patients in hospital in a Chinese population.
MedLine Citation:
PMID:  9309539     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There are many pathological causes and potential mechanisms for hypercalcemia. We measured intact parathyroid hormone (PTH) and parathyroid hormone related protein (PTHrP) in the hypercalcemic in-patients and attempted to evaluate the roles of PTH and PTHrP in hypercalcemia due to malignancy. We performed a prospective study of 178 patients with corrected serum calcium concentrations greater than 2.74 mmol/l in a hospital over a 3-year period. We measured calcium and albumin using a Hitachi 747 autoanalyzer, and we measured PTH and PTHrP by two-site immunoradiometric assays (IRMA). Hypercalcemia was attributed to malignancy alone in 93 patients (52.3%), primary hyperparathyroidism (HPT) alone in 28 patients (15.7%), uremia with hemodialysis in 23 patients (12.9%), unknown in 16 patients (9%), primary HPT coexisting with malignancy in 7 patients (3.9%) and other rare causes (6.2%). Plasma PTHrP levels were elevated in 71/93 (76.3%) patients with hypercalcemia due to malignancy, but the elevated PTHrP percentage differed for each kind of tumor. PTHrP levels were elevated in 100% of patients with squamous carcinomas (CA) in the lung, esophagus, skin, cholangiocarcinoma of liver, and breast CA. The positive bony metastatic rate was 44.1% (41/93). There was no correlation between high PTHrP and bony metastasis. There was a good correlation between the corrected serum calcium and PTHrP levels (r = 0.476, p < 0.001), but no correlation between survival time and serum calcium level or PTHrP level. There was no significant difference in life expectancy after cancer diagnosis between the high PTHrP group and normal PTHrP group, and there was no significant difference in life expectancy after the first occurrence of hypercalcemia between the two groups. Measurement of both PTH and PTHrP levels led to a change in the initial diagnosis in 7 patients. In routine practice, measurement of serum PTH alone is not enough. This study suggests that the appropriate combination of PTH and PTHrP assays results in a more accurate diagnosis of the hypercalcemic causes. In addition, especially high PTHrP levels should be screened for malignancy. However, the prognosis in cancer patients after hypercalcemia with high PTHrP group, as compared to those with the normal PTHrP group is not significantly different.
Authors:
J K Lee; M J Chuang; C C Lu; L J Hao; C Y Yang; T M Han; H C Lam
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of endocrinological investigation     Volume:  20     ISSN:  0391-4097     ISO Abbreviation:  J. Endocrinol. Invest.     Publication Date:    1997 Jul-Aug
Date Detail:
Created Date:  1997-10-30     Completed Date:  1997-10-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7806594     Medline TA:  J Endocrinol Invest     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  404-9     Citation Subset:  IM    
Affiliation:
Department of Medicine, Veterans General Hospital-Kaohsiung, Taipei, Taiwan, Republic of China.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Bone Neoplasms / secondary
Calcium / blood
Female
Humans
Hypercalcemia / blood*,  etiology
Hyperparathyroidism / complications
Immunoradiometric Assay
Male
Middle Aged
Neoplasms / complications
Parathyroid Hormone / blood*
Parathyroid Hormone-Related Protein
Prospective Studies
Proteins / analysis*
Reference Values
Renal Dialysis
Taiwan
Uremia / complications,  therapy
Chemical
Reg. No./Substance:
0/PTHLH protein, human; 0/Parathyroid Hormone; 0/Parathyroid Hormone-Related Protein; 0/Proteins; 7440-70-2/Calcium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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