Considerations in parathyroid hormone testing

Cavalier, Étienne; Plebani, Mario; Delanaye, Pierre; Souberbielle, Jean‐Claude

doi:10.1515/cclm-2015-0314

Cited by 28 publications

(23 citation statements)

References 46 publications

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“…To avoid misclassification due to circadian and seasonal rhythms and to physical exercise [69], which can influence serum PTH concentrations, and blood contamination which can potentially affect FNA-PTH levels, we suggest as positive cutoff the FNA-PTH/serum PTH ratio ≥ 2 (Table 6). We also advise to measure FNA-PTH in the same laboratory with the same sample preparation and the same IMA method [70,71]. Some potential minor complications were reported during surgery of patients who underwent FNA of parathyroid; there, 6% of cases had signs of inflammatory responses; consequently, a conversion from mini-invasive to open surgical approaches was required in some cases [72].…”

Section: Measurement Of Pth In Fna Fluids From Suspicious Hyperplastimentioning

confidence: 99%

Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids

Trimboli

D’Aurizio

Tozzoli

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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Different imaging tools, circulating endocrine markers, and fine-needle aspiration (FNA) cytology are of great importance in the diagnosis and follow-up of different thyroid and parathyroid diseases. Sometimes, however, they are conflicting or inconclusive: interestingly, measuring endocrine markers (i.e. thyroglobulin, calcitonin, parathyroid hormone) in fluids from FNA proved to be a very useful complementary diagnostic tool in such cases. The determination of endocrine markers in fluids other than serum/ plasma has been developed in the last years. Although studies have reported overall satisfactory results, a good standardization of procedures has not yet been reached, and further efforts should be made in order to better define preanalytical, analytical, and post-analytical aspects. Here we reviewed critically the literature on the measurement of FNA endocrine markers, focusing on laboratory issues, such as preparation of the sample, choice of solution, and technical features of determination of these markers. Indeed, information for use of FNA-Tg, FNA-CT, and FNA-PTH in clinical practice was also provided.

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Section: Measurement Of Pth In Fna Fluids From Suspicious Hyperplastimentioning

confidence: 99%

Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids

Trimboli

D’Aurizio

Tozzoli

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…Недостатком дан-ных наборов является то, что они также распознают молекулу ПТГ1-84, претерпевшую посттрансляци-онные изменения (фосфорилирование по серину) на участке [15][16][17][18][19][20] Кальцимиметическое действие со снижением концентрации ПТГ и как следствие уменьшение содер-жания кальция в сыворотке крови Терипаратид Рекомбинантный человеческий ПТГ, подобно эндогенному гормону увеличивает кишечную абсорб-цию и канальцевую реабсорбцию кальция, потенциально может определяться в рамках гормонального анализа молекулы в конечный уровень ПТГ, измеренного с помощью наборов третьего поколения, составляет менее 10% у здоровых лиц и до 15% у лиц с почечной недостаточностью. N-ПТГ может в избытке проду-цироваться при карциноме ОЩЖ и тяжелом гипер-паратиреозе [29]. При проведении оценки чувствительности на-боров второго и третьего поколения для диагности-ки ПГПТ не получено клинически значимых разли-чий (91,3% против 89,1% соответственно) [30].…”

Section: лабораторная диагностикаunclassified

Primary hyperparathyroidism: the clinical picture, diagnostics, differential diagnostics, and methods of treatment

Dedov

Иванович²,

Мельниченко

et al. 2017

Probl Endokrinol (Mosk)

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Primary hyperparathyroidism (PHT) is the third most common endocrine disorder in men and women after diabetes mellitus and thyroid disease and one of the most frequent causes of osteoporosis and fractures among the secondary osteopathy. PHT refers to socially significant problems in connection with involvement in the pathological process of the majority of organs and system In recent years, the conception of epidemiology, clinic and tactics of management of patients with PHT has changed due to significant increase of morbidity at the expense of identification of mild forms of disease. The modern management concept tactics depends on clinical manifestations. Bearing in mind the importance of the problem under consideration, the working group was set up for the development of federal recommendations on the treatment of PHT based on the principles of evidence-based medicine. The experience accumulated by the domestic and international experts was summarized in the federal clinical guidelines on PHT.

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“…PTH is a single-chain hormone, consisting of 84 amino acids, which is mainly produced by chief cells in parathyroid glands. PTH has a relative molecular weight of 9.5 kD and is cleaved from pre-pro-PTH (115 amino acids) and then from pro-PTH (90 amino acids) [4]. The latter then splits into active (1-84)PTH, which is stored in secretory granules.…”

Section: Introductionmentioning

confidence: 99%

Effects of Parathyroidectomy on Plasma iPTH and (1–84) PTH Levels in Patients with Stage 5 Chronic Kidney Disease

et al. 2018

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Currently, the second-generation intact parathyroid hormone (iPTH) assay is commonly used for measuring PTH levels. The iPTH assay detects both full-length (1-84)PTH and (7-84)PTH fragments, which have antagonistic effects on (1-84)PTH in bones and kidneys. The third-generation PTH assay is specific for (1-84)PTH. This study examined the features of different PTH fragments in stage 5 chronic kidney disease (CKD) and the effects of parathyroidectomy (PTX) on the above markers in severe secondary hyperparathyroidism (SHPT) patients. The cross-sectional study included 262 stage 5 CKD patients and 90 controls. A prospective follow-up study was then conducted in 34 PTX patients. Second- and third-generation assays were used to measure plasma iPTH and (1-84)PTH levels, respectively. Circulating (7-84)PTH levels were calculated by subtracting the (1-84)PTH value from the iPTH value. Different plasma PTH fragments were higher, and (1-84)PTH/iPTH was lower in CKD patients than in controls. Plasma (1-84)PTH and (7-84)PTH concentrations increased as iPTH levels increased, and (7-84)PTH increased more evidently. Plasma iPTH, (1-84)PTH and (7-84)PTH levels were 1530.5 (885.0-2111.5) pg/ml, 683.1 (431.4-1018.0) pg/ml, and 739.3 (452.6-1261.0) pg/ml, respectively, in PTX patients. Plasma iPTH, (1-84)PTH and (7-84)PTH concentrations decreased considerably, and the (1-84)PTH/iPTH ratio increased after PTX (median follow-up interval: 10.9 months). Stage 5 CKD patients had higher plasma levels of different PTH fragments, and lower (1-84)PTH/iPTH ratio. PTX could significantly reverse these abnormalities in severe SHPT patients. The iPTH assay overestimated the function of the parathyroid glands; thus, the third-generation PTH assay is likely better for the management of CKD patients.

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Considerations in parathyroid hormone testing

Cited by 28 publications

References 46 publications

Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids

Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids

Primary hyperparathyroidism: the clinical picture, diagnostics, differential diagnostics, and methods of treatment

Effects of Parathyroidectomy on Plasma iPTH and (1–84) PTH Levels in Patients with Stage 5 Chronic Kidney Disease

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