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. 1971 Oct;50(10):2079–2083. doi: 10.1172/JCI106701

Immunologic differentiation of primary hyperparathyroidism from hyperparathyroidism due to nonparathyroid cancer

B Lawrence Riggs 1,2,3,4, Claude D Arnaud 1,2,3,4, James C Reynolds 1,2,3,4, Lynwood H Smith 1,2,3,4
PMCID: PMC292141  PMID: 4330004

Abstract

Serum immunoreactive parathyroid hormone (IPTH) was measured by radioimmunoassay in 54 patients with primary hyperparathyroidism and in 18 consecutive patients with ectopic hyperparathyroidism due to nonparathyroid cancer without apparent skeletal metastasis. Although serum calcium concentration was higher in the group with ectopic hyperparathyroidism, serum IPTH was lower (rank sum test, P < 0.001) and was undetectable in eight. A second anti-PTH antiserum also differentiated between IPTH in the two groups, although IPTH was undetectable in only 1 of 14 sera. When IPTH values in serial dilutions were plotted, slopes for the two patients with ectopic hyperparathyroidism who had relatively high IPTH were less (P < 0.001) than slopes for standard hyperparathyroid sera. By using differences in either IPTH rank or slope of the dilutional curve of sera, primary hyperparathyroidism could be excluded as a cause of the hypercalcemia in 16 of the 18 patients with ectopic hyperparathyroidism. The data are interpreted as indicating that PTH-like material in the serum of these patients with ectopic hyperparathyroidism is immunologically different from the PTH in the serum of patients with primary hyperparathyroidism.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arnaud C. D., Sizemore G. W., Oldham S. B., Fischer J. A., Tsao H. S., Littledike E. T. Human parathyroid hormone: glandular and secreted molecular species. Am J Med. 1971 May;50(5):630–638. doi: 10.1016/0002-9343(71)90118-5. [DOI] [PubMed] [Google Scholar]
  2. Arnaud C. D., Tsao H. S., Littledike T. Radioimmunoassay of human parathyroid hormone in serum. J Clin Invest. 1971 Jan;50(1):21–34. doi: 10.1172/JCI106476. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Arnaud C. D., Tsao H. S., Oldham S. B. Native human parathyroid hormone: an immunochemical investigation. Proc Natl Acad Sci U S A. 1970 Sep;67(1):415–422. doi: 10.1073/pnas.67.1.415. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Berson S. A., Yalow R. S. Immunochemical heterogeneity of parathyroid hormone in plasma. J Clin Endocrinol Metab. 1968 Jul;28(7):1037–1047. doi: 10.1210/jcem-28-7-1037. [DOI] [PubMed] [Google Scholar]
  5. Berson S. A., Yalow R. S. Parathyroid hormone in plasma in adenomatous hyperparathyroidism, uremia, and bronchogenic carcinoma. Science. 1966 Nov 18;154(3751):907–909. doi: 10.1126/science.154.3751.907. [DOI] [PubMed] [Google Scholar]
  6. Keating F. R., Jr, Jones J. D., Elveback L. R., Randall R. V. The relation of age and sex to distribution of values in healthy adults of serum calcium, inorganic phosphorus, magnesium, alkaline phosphatase, total proteins, albumin, and blood urea. J Lab Clin Med. 1969 May;73(5):825–834. [PubMed] [Google Scholar]
  7. Knill-Jones R. P., Buckle R. M., Parsons V., Calne R. Y., Williams R. Hypercalcemia and increased parathyroid-hormone activity in a primary hepatoma. Studies before and after hepatic transplantation. N Engl J Med. 1970 Mar 26;282(13):704–708. doi: 10.1056/NEJM197003262821302. [DOI] [PubMed] [Google Scholar]
  8. Lafferty F. W. Pseudohyperparathyroidism. Medicine (Baltimore) 1966 May;45(3):247–260. doi: 10.1097/00005792-196605000-00004. [DOI] [PubMed] [Google Scholar]
  9. Munson P. L., Tashjian A. H., Jr, Levine L. Evidence for parathyroid hormone in nonparathyroid tumors associated with hypercalcemia. Cancer Res. 1965 Aug;25(7):1062–1067. [PubMed] [Google Scholar]
  10. Roof B. S., Carpenter B., Fink D. J., Gordan G. S. Some thoughts on the nature of ectopic parathyroid hormones. Am J Med. 1971 May;50(5):686–691. doi: 10.1016/0002-9343(71)90124-0. [DOI] [PubMed] [Google Scholar]
  11. Sherwood L. M., Lundberg W. B., Jr, Targovnik J. H., Rodman J. S., Seyfer A. Synthesis and secretion of parathyroid hormone in vitro. Am J Med. 1971 May;50(5):658–669. doi: 10.1016/0002-9343(71)90121-5. [DOI] [PubMed] [Google Scholar]
  12. Sherwood L. M., O'Riordan J. L., Aurbach G. D., Potts J. T., Jr Production of parathyroid hormone by nonparthyroid tumors. J Clin Endocrinol Metab. 1967 Jan;27(1):140–146. doi: 10.1210/jcem-27-1-140. [DOI] [PubMed] [Google Scholar]
  13. Sherwood L. M., Rodman J. S., Lundberg W. B. Evidence for a precursor to circulating parathyroid hormone. Proc Natl Acad Sci U S A. 1970 Nov;67(3):1631–1638. doi: 10.1073/pnas.67.3.1631. [DOI] [PMC free article] [PubMed] [Google Scholar]

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