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Biochemical Test

Biochemical Test. Serum Calcium to confirm increase in calcium as action of the parathyrod hormone Normal: 8.5 mg/ dL Normal ionized: 4.4 – 5.2 mg/ dL Elevated calcium be tested with level of PTH for: hyperparathyroidism Malignancy. Izza. Biochemical Test. Parathyroid Hormone (PTH)

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Biochemical Test

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  1. Biochemical Test • Serum Calcium • to confirm increase in calcium as action of the parathyrod hormone • Normal: 8.5 mg/dL • Normal ionized: 4.4 – 5.2 mg/dL • Elevated calcium be tested with level of PTH for: • hyperparathyroidism • Malignancy Izza

  2. Biochemical Test • Parathyroid Hormone (PTH) • Normal: 10 - 50 mg/dL • can distinguish PHPT vs other causes of hypercalcemia • hypercalcemia + intact PTH = PHPT • Hypercalcemia + low PTH = malignancy • Elevated parathyroid hormone (PTH) levels in the setting of hypercalcemia establish the diagnosis of hyperparathyroidism Izza

  3. Biochemical Test • Serum phosphate • decreased serum phosphate level of less than 2.5 mg/dL (0.81 mmol/L) • Cl: PO4 ratio is elevated = mild hyperchloremic acidosis (>33) • Calcium - Creatinine Ratio : elevated (>0.02) • Normal: <0.01 Izza

  4. Biochemical Test • Urinalysis • For patients not previously documented normocalcemia or a family history of hypercalcemia • Elevated 24 hr urinary calcium: benign familial hypocalciurichypercalcemia (BFHH) • >100 mg/day • Normal or increase in uric acid • Unchange or decrease in Mg • Alkaline phosphatase • increase due to Increased bone turnover reflected as elevated levels of markers of bone formation • marker of bone resorption is also noted: increase urinary pyridinoline • present in 10% of patients with PHPT Izza

  5. Biochemical Test • Vitamin D3 • Occasionally normal of increased • Normocalcemic PHPT • Vit. D deficiency • Low serum albumin • Excessive hydration • High phosphate diet Izza

  6. Laboratory test result • Serum calcium = 20 mg/dLelevated • Ionized calcium = 8 mg/dLelevated • Serum PTH level = 70 mg/dLelevated • Hypercalcemia + elevated PTH level • rule out malignancy • hyperparathyroidism Izza

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