Serum ionized calcium and corrected total calcium in borderline hyperparathyroidism.

1978 ◽  
Vol 24 (11) ◽  
pp. 1962-1965 ◽  
Author(s):  
L Larsson ◽  
S Ohman

Abstract We studied 25 borderline-hyperparathyroidism patients whose total serum calcium concentration was within normal limits (reference range: 2.25--2.75 mmol/liter) but whose concentrations of serum ionized calcium were above normal (reference range: 1.03--1.23 mmol/liter). Their hyperparathyroidism was histopathologically verified. To compare the discriminating value of corrected serum calcium with ionized calcium, we studied the serum calcium and albumin concentrations in a reference group of 2098 patients. After patients from endocrine and dialysis departments were excluded from the reference group, we obtained the range (mean +/- 2 SD) 2.05--2.71 mmol/liter for uncorrected serum calcium and 2.11--2.63 mmol/liter for corrected serum calcium. The correction factor for calcium on albumin was 20 mumol/g. Even with this limit for corrected serum calcium, 13 of 25 borderline hyperparathyroidism patients had values that fell within the reference range. We conclude that correcting total serum calcium values for serum albumin concentration improves discrimination of borderline hyperparathyroid patients, but that measurement of ionized calcium in serum discriminates better.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rahel D. Gebreyohannes ◽  
Ahmed Abdella ◽  
Wondimu Ayele ◽  
Ahizechukwu C. Eke

Abstract Background Preeclampsia is a well-known cause of maternal mortality and morbidity in Ethiopia. The exact pathophysiology has not been fully understood. Calcium and magnesium deficiencies have been given emphasis to play roles in the pathophysiology. Although evidence is abundant, they are equivocal. The study aimed to see the association of dietary calcium intake, serum total calcium level and ionized calcium level with preeclampsia. It also evaluated the association between dietary calcium intake and serum calcium levels. Materials and methods An unmatched case–control study was conducted in Gandhi Memorial, Tikur Anbessa, and Zewditu Memorial Hospitals, all in Addis Ababa, between October to December, 2019. Cases were 42 women with preeclampsia and controls were 42 normotensive women. The medical and obstetric history was gathered using a structured questionnaire and the dietary calcium intake information using a 24-h dietary recall. The serum levels of total serum calcium and ionized (free) calcium were measured using an inductively coupled mass spectrophotometer. Bivariate and multivariate logistic regression and Pearson correlation test were utilized during data analysis. Results In comparison with controls, women with preeclampsia had lower mean (± 1SD) levels of ionized calcium level (1.1 mmol/l ± 0.11), total serum calcium level (1.99 mmol/l ± 0.35) and lower median (IQR) dietary calcium intake (704 mg/24 h,458–1183). The odds of having preeclampsia was almost eight times greater in those participants with low serum ionized calcium level (OR 7.5, 95% CI 2.388–23.608) and three times higher in those with low total serum calcium level (OR 3.0, 95% CI 1.024–9.370). Low dietary calcium intake also showed statistically significant association with preeclampsia (OR 3.4, 95% CI 1.092 -10.723). Serum ionized calcium level and total serum calcium level showed positive correlation of moderate strength (p = 0.004, r = 0.307), but no correlation was found between dietary calcium intake with both forms of serum calcium levels. Conclusion This study showed significant association between low dietary calcium intake and low serum calcium levels with preeclampsia, hence this can be used as a supportive local evidence for the current context-specific recommendation of calcium supplementation in societies with low-dietary calcium consumption in an attempt to prevent preeclampsia, therefore implementation study should be considered in Ethiopia to look for the feasibility of routine supplementation.


1987 ◽  
Vol 92 (2) ◽  
pp. 147-176 ◽  
Author(s):  
Lars Benson ◽  
Sverker Ljunghall ◽  
Torgny Groth ◽  
Hans Falk ◽  
Andreas Hvarfner ◽  
...  

1970 ◽  
Vol 16 (3) ◽  
pp. 226-228 ◽  
Author(s):  
Genevieve Farese ◽  
Milton Mager ◽  
William F Blatt

Abstract A rapid, simple procedure is described for separating diffusible from proteinbound serum calcium by centrifugation through high-flux ultrafiltration membranes. The mean normal value for ultrafilterable calcium was 57.1% (range 52 to 61%) of the total serum calcium concentration.


1978 ◽  
Vol 87 (4) ◽  
pp. 743-750 ◽  
Author(s):  
Leif Mosekilde ◽  
Merete Sanvig Christensen ◽  
Flemming Melsen ◽  
Niels Schwartz Sørensen

ABSTRACT The effect of antithyroid treatment on the disturbed calcium-phosphorus metabolism in hyperthyroidism was studied in 16 patients. Elevated serum concentrations and urinary excretions of calcium and phosphorus were almost normalized 4 weeks after the start of medical treatment. Serum immunoreactive parathyroid hormone was decreased in the hyperthyroid state and became normal after medical treatment. Serum alkaline phosphatase levels were elevated throughout the study with an increase to a maximum peak after 8 weeks of antithyroid treatment. Urinary hydroxyproline excretion was initially markedly increased and fell rapidly during therapy. The observed changes suggest decreased bone resorption and increased bone formation with deposition of bone mineral after antithyroid treatment. Alterations in the serum albumin concentration during the investigation period influenced the total serum calcium concentration. Using albumin adjusted serum calcium values no hypocalcaemia was found during medical treatment or after a subsequent subtotal thyroidectomy.


2018 ◽  
Vol 146 (9-10) ◽  
pp. 512-515 ◽  
Author(s):  
Tatjana Smiljkovic ◽  
Svetlana Kostic-Dedic ◽  
Vesna Nikolic ◽  
Andjela Gavrilovic ◽  
Sanja Jevdjic

Introduction/Objective. An association between restless legs syndrome (RLS) and etiologically different polyneuropathies is well established. However, the investigations about the prevalence of RLS in diabetic polyneuropathy (DP) have led to controversy. Our study objective was to determine the frequency of RLS in patients with distal symmetrical polyneuropathy in patients with diabetes and identify possible risk factors for its occurrence in this group of patients. Method. We investigated 101 consecutive patients with distal DP. RLS was diagnosed according to the International RLS Study Group diagnostic criteria. The distal symmetrical polyneuropathy was confirmed by the electromyoneurographic study performed in each patient. Results. Overall RLS was present in 27 (26.73%) patients. The comparison between patients with and without RLS revealed that the RLS+ group included more women than men (14.85/9.90% vs. 35.64/37.62%, non-significant), patients were significantly younger (60.58 ? 10.54 vs. 65.57 ? 10.94 years, p ? 0.05), sensory polyneuropathy was significantly more common (17/27 vs. 34/74, p ? 0.05); the average level of the total serum calcium concentration was higher in the RLS + group than in non-RLS (2.43 ? 0.26 vs. 2.28 ? 0.39; p ? 0.05). However, multivariate logistic regression analysis did not demonstrate these as significant independent risk factors for RLS in DP. Conclusions. RLS is common in DP and occurs in more than a quarter of these patients. Though sensory forms and higher total serum calcium concentration were associated with RLS, neither of these has been identified as a significant single risk factor for the development of RLS in DP.


PEDIATRICS ◽  
1986 ◽  
Vol 78 (3) ◽  
pp. 541-542
Author(s):  
JENS MÖLLER ◽  
F. K. TEGTMEYER

To the Editor.— We would like to add some comments on the article by Venkataraman et al.1 In one respect it might be quite dangerous not to measure the ionized calcium in preterm neonates. If you find prolongation of QTc or QoTc intervals in the ECG during cardiac failure in these infants and find subnormal total serum calcium levels, you might make a wrong conclusion on causal relationship. Until now, we have seen five preterm neonates with OTc/QoTc prolongation and profound low total serum calcium levels, whereas the measured ionized calcium level was normal.


2020 ◽  
Vol 6 (3) ◽  
pp. e127-e131
Author(s):  
Matthew C. Moccia ◽  
Eli E. Miller ◽  
Cherie L. Vaz

Objective: To discuss the diagnosis and management of occult primary hyperparathyroidism. Methods: We present the biochemical and radiologic evaluation, treatment, and outcome of a woman with occult primary hyperparathyroidism which presented as an unusual neck mass on ultrasound. We also present a relevant literature review. Results: A 52-year-old female presented with Hashimoto thyroiditis and a 1.2-cm, hypoechoic oval nodule in the left upper lateral portion of the thyroid. She returned a decade later with a 2.2-cm, hypervascular mass on ultrasound. Parathyroid hormone was mildly elevated at 90 pg/mL (reference range is 15 to 65 pg/mL), but she had persistently normal levels of total serum calcium at 9.9 mg/dL (reference range is 8.7 to 10.3 mg/dL), phosphorus at 3.5 mg/dL (reference range is 2.1 to 4.5 mg/dL), and albumin at 4.4 g/dL (reference range is 3.6 to 4.8 g/dL). She had elevated ionized calcium of 5.9 mg/dL (reference range is 4.5 to 5.6 mg/dL). Computed tomography with contrast of the neck revealed an enhancing oval lesion abutting the superior pole of the left thyroid with attenuation characteristics similar though slightly different from the thyroid. 99mTc-Sestamibi scan showed increased uptake posterior to the superior aspect of the left thyroid. Bone densitometry showed osteoporosis of the left distal radius and osteopenia of the left femoral neck. Minimally invasive radio-guided parathyroidectomy was performed with normalization of parathyroid hormone. Pathology confirmed a 1.715-g parathyroid adenoma. Conclusion: Despite normal total calcium levels, clinically significant primary hyperparathyroidism may present as a large adenoma which could appear as a hypervascular neck mass on ultrasound. A high index of suspicion based on ultrasound features and measurement of ionized calcium may be helpful in diagnosing occult, but clinically relevant primary hyperparathyroidism.


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