Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (1100 page)

BOOK: Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis
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Normal range:
12–65 pg/mL.
   Use
   Differential diagnosis of hyperparathyroidism and hypoparathyroidism.
   Very sensitive in detecting PTH suppression by 1,25-dihydroxyvitamin D; therefore, used for monitoring that treatment of chronic renal failure.
   Intraoperative PTH assay to determine removal of abnormally secreting tissue; may replace routine frozen section; can replace traditional four-gland explorations and distinguishes single from multiglandular disease.
   Preoperative and 10–20 minutes postresection assay; this causes 50–75% reduction, indicating successful resection of parathyroid adenoma.
   Interpretation

Increased In

   Primary and secondary hyperparathyroidism
   Pseudohypoparathyroidism
   Hereditary vitamin D dependency types 1 and 2, vitamin D deficiency
   Z-E syndrome
   Familial medullary thyroid carcinoma
   MEN types I, IIa, and IIb

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