INCREASED SERUM CALCIUM IS NOT COMMON IN HOSPITALIZED PATIENTS WITH PRIMARY HYPERPARATHYROIDISM: A RETROSPECTIVE, OBSERVATIONAL STUDY

2020 ◽  
Vol 26 (3) ◽  
pp. 285-290
Author(s):  
Muhammad Abu Tailakh ◽  
Ahmad Yahia ◽  
Ilia Polischuck ◽  
Yair Liel
Keyword(s):  
Primary Hyperparathyroidism ◽  
Serum Calcium ◽  
Medical Records ◽  
Reference Range ◽  
Laboratory Data ◽  
Hospitalized Patients ◽  
Total Serum ◽  
Normal Reference Range ◽  
Total Serum Calcium ◽  
The Mean

Objective: Serum calcium levels often decrease during acute illness in patients with an intact calcium-regulating system. However, the dynamics of serum calcium levels in hospitalized patients with primary hyperparathyroidism (PHPT) have not yet been described. Methods: Clinical and laboratory data were retrospectively retrieved from the electronic medical records of patients with PHPT before, during, and after hospitalization for various reasons (excluding parathyroid surgery). Results: There were 99 nonselected patients with asymptomatic, hypercalcemic PHPT, hospitalized for various reasons; 42% were admitted for apparent infectious or septic conditions, and 58% were admitted for noninfectious conditions. Total serum calcium increased >0.5 mg/dL in 7.4% of the patients: 10.9% and 2.5% of the patients with noninfectious and infectious conditions, respectively. In 65.7% of the patients, the mean total serum calcium (TsCa), but not albumin-corrected calcium (corrCa), decreased significantly during hospitalization, down to below the upper limit of the reference range. Although prehospitalization TsCa and corrCa were similar in patients with infectious and noninfectious conditions, during hospitalization, TsCa was lower in patients with infectious conditions ( P = .02). Both TsCa and albumin returned to prehospitalization levels after recovery. Conclusion: TsCa increases in a minority of hospitalized PHPT patients. In the majority of hospitalized patients with PHPT, TsCa, but not corrCa, decreases to within the normal reference range, more so in patients with infectious conditions, obscuring the major characteristic of PHPT. Therefore, it is prudent to follow calcium and corrCa during hospitalization in patients with PHPT. Abbreviations: corrCa = albumin-corrected serum calcium; IQR = interquartile range; PHPT = primary hyperparathyroidism; PTH = parathyroid hormone; TsCa = total serum calcium

Intraoperative monitoring of kinetic total serum calcium levels in primary hyperparathyroidism surgery1 1No competing interests declared.

2004 ◽  
Vol 198 (4) ◽  
pp. 519-524 ◽  
Author(s):  
Francisco Javier Dı́az-Aguirregoitia ◽  
Carlos Emparan ◽  
Sonia Gaztambide ◽  
Maria Angeles Aniel-Quiroga ◽  
Maria Angeles Busturia ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Serum Calcium ◽  
Intraoperative Monitoring ◽  
Total Serum ◽  
Competing Interests ◽  
Total Serum Calcium

Primary Hyperparathyroidism

1964 ◽  
Vol 10 (3) ◽  
pp. 228-234 ◽  
Author(s):  
H O Nicholas ◽  
James Allen Chamberlin
Keyword(s):  
Primary Hyperparathyroidism ◽  
Serum Calcium ◽  
Test Procedure ◽  
Total Serum ◽  
Renal Lithiasis ◽  
Routine Test ◽  
Total Serum Calcium ◽  
Reliable Diagnosis ◽  
The Subject

Abstract This paper presents the final results obtained by this laboratory during a 3½-year investigation of primary hyperparathyroidism. The project involved establishment of a routine test procedure for more reliable diagnosis of this condition; a study of the incidence of renal lithiasis in hyperparathyroidism, and, finally, the subject of the present paper-the obtaining of data to construct a nomogram for estimation of diffusible serum calcium from the total serum calcium and the albumin and globulin levels.

A Membrane Ultrafiltration Procedure for Determining Diffusible Calcium in Serum

1970 ◽  
Vol 16 (3) ◽  
pp. 226-228 ◽  
Author(s):  
Genevieve Farese ◽  
Milton Mager ◽  
William F Blatt
Keyword(s):  
Serum Calcium ◽  
Calcium Concentration ◽  
Simple Procedure ◽  
Total Serum ◽  
High Flux ◽  
Ultrafiltration Membranes ◽  
Serum Calcium Concentration ◽  
Normal Value ◽  
Total Serum Calcium ◽  
The Mean

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.

scholarly journals Serum calcium levels in newly detected essential hypertensive patients

2021 ◽  
Vol 8 (10) ◽  
pp. 1539
Author(s):  
Arumugam Aashish ◽  
Jayasingh Kannaiyan
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Serum Calcium ◽  
Systemic Hypertension ◽  
Total Serum ◽  
Newly Diagnosed ◽  
Mortality And Morbidity ◽  
Total Serum Calcium ◽  
The Mean ◽  
Significant Mortality

Background: Systemic hypertension is global disease responsible for significant mortality and morbidity. Essential or primary hypertension accounts for the majority of people with hypertension. Although our understanding of the pathophysiology of essential hypertension has grown a lot, its aetiology still remains hypothetical. Few studies in literature have found some correlation with serum calcium levels and blood pressure of the individuals.Methods: A total 200 patients, 100 newly diagnosed essential hypertensive and 100 normotensive patients were included in the study. A detailed history and clinical profile was taken. Blood sample was collected and serum calcium, serum albumin were determined and corrected calcium was calculated and the results were tabulated and appropriate statistical analysis was done.Results: The mean total serum calcium and corrected calcium levels were significantly lowered in essential hypertensive compared to the normotensive individuals. There was no correlation between total serum and corrected calcium levels against systolic and diastolic blood pressure. There was also no difference in serum total and corrected calcium levels among different subsets in essential hypertensive group.Conclusion: Essential hypertension still remains the most common form of hypertension present worldwide causing significant mortality and morbidity. Despite increased advances in medicine and large number of studies done in context with the cause of essential hypertension, its aetiology still remains hypothetical. Even though studies have shown some correlation of calcium fractions with hypertension, the aetiology is still unclear.

scholarly journals OCCULT PRIMARY HYPERPARATHYROIDISM: A CASE REPORT AND REVIEW OF PARATHYROID ULTRASONOGRAPHY

2020 ◽  
Vol 6 (3) ◽  
pp. e127-e131
Author(s):  
Matthew C. Moccia ◽  
Eli E. Miller ◽  
Cherie L. Vaz
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Reference Range ◽  
Relevant Literature ◽  
Hashimoto Thyroiditis ◽  
Neck Mass ◽  
Ionized Calcium ◽  
Total Serum ◽  
Radiologic Evaluation ◽  
Total Serum Calcium

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.

Serum ionized calcium and corrected total calcium in borderline hyperparathyroidism.

1978 ◽  
Vol 24 (11) ◽  
pp. 1962-1965 ◽  
Author(s):  
L Larsson ◽  
S Ohman
Keyword(s):  
Serum Calcium ◽  
Reference Range ◽  
Reference Group ◽  
Ionized Calcium ◽  
Total Serum ◽  
Albumin Concentration ◽  
Serum Calcium Concentration ◽  
Normal Limits ◽  
Total Serum Calcium ◽  
Serum Ionized Calcium

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.

Intraoperative monitoring of kinetic total serum calcium levels in primary hyperparathyroidism operation

2004 ◽  
Vol 199 (6) ◽  
pp. 1000-1001
Author(s):  
Farah Arshad ◽  
Anand K. Mishra ◽  
A.K. Verma ◽  
Gaurav Agarwal ◽  
Amit Agarwal ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Serum Calcium ◽  
Intraoperative Monitoring ◽  
Total Serum ◽  
Total Serum Calcium

scholarly journals Cinacalcet normalizes serum calcium in a double-blind randomized, placebo-controlled study in patients with primary hyperparathyroidism with contraindications to surgery

2015 ◽  
Vol 172 (5) ◽  
pp. 527-535 ◽  
Author(s):  
Aliya Khan ◽  
John Bilezikian ◽  
Henry Bone ◽  
Andrey Gurevich ◽  
Peter Lakatos ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Serum Calcium ◽  
Controlled Study ◽  
Total Serum ◽  
Open Label ◽  
Double Blind ◽  
Serum Calcium Concentration ◽  
Total Serum Calcium ◽  
Normal Mean ◽  
Serum Pth

ObjectivePrimary hyperparathyroidism (PHPT) is diagnosed by the presence of hypercalcemia and elevated or nonsuppressed parathyroid hormone (PTH) levels. Although surgery is usually curative, some individuals fail or are unable or unwilling to undergo parathyroidectomy. In such individuals, targeted medical therapy may be of value. Cinacalcet normalized calcium level and lowered PTH in patients with PHPT in several phase 2 and open-label studies. We compared cinacalcet and placebo in subjects with PHPT unable to undergo parathyroidectomy.DesignPhase 3, double-blind, multi centere, randomized, placebo-controlled study.MethodsSixty-seven subjects (78% women) with moderate PHPT were randomized (1:1) to cinacalcet or placebo for ≤28 weeks.Main outcome measureAchievement of a normal mean corrected total serum calcium concentration of ≤10.3 mg/dl (2.575 mmol/l).ResultsBaseline median (quartile 1 (Q1), Q3) serum PTH was 164.0 (131.0, 211.0) pg/ml and mean (s.d.) serum Ca was 11.77 (0.46) mg/dl. Serum Ca normalized (≤10.3 mg/dl) in 75.8% of cinacalcet- vs 0% of placebo-treated subjects (P<0.001). Corrected serum Ca decreased by ≥1.0 mg/dl from baseline in 84.8% of cinacalcet- vs 5.9% of placebo-treated subjects (P<0.001). Least squares mean (s.e.m.) plasma PTH change from baseline was −23.80% (4.18%) (cinacalcet) vs −1.01% (4.05%) (placebo) (P<0.001). Similar numbers of subjects in the cinacalcet and placebo groups reported adverse events (AEs) (27 vs 20) and serious AEs (three vs four). Most commonly reported AEs were nausea and muscle spasms.ConclusionsThese results demonstrate that cinacalcet normalizes serum calcium in this PHPT population and appears to be well tolerated.

scholarly journals Correlation between corrected serum calcium and serum albumin in children with idiopathic nephrotic syndrome in North central, Nigeria

2021 ◽  
Vol 8 (2) ◽  
pp. 207
Author(s):  
Ozohu A. Aliyu ◽  
Shamsudeen Mohammed ◽  
Yakubu Abdullahi
Keyword(s):  
Nephrotic Syndrome ◽  
Serum Albumin ◽  
Serum Calcium ◽  
Idiopathic Nephrotic Syndrome ◽  
Ionized Calcium ◽  
Total Serum ◽  
Healthy Children ◽  
Positive Correlation ◽  
Total Serum Calcium ◽  
The Mean

Background: Nephrotic syndrome is a clinical condition caused by alteration of glomerular membrane permeability resulting in a net loss of protein, and vitamin D binding proteins in urine leading to hypoalbuminaemia and hypocalcaemia. A positive correlation between serum albumin and ionized calcium in childhood nephrotic syndrome has been described but the correlation between total serum calcium or corrected serum calcium and serum albumin has not been extensively described.Methods: This study was carried out at Dalhatu Araf Specialist Hospital, Lafia Nigeria. Fifteen children with idiopathic nephrotic syndrome were recruited consecutively as the cases, 15 age and gender matched healthy children were recruited as the controls. Total serum calcium and albumin was assayed in all these children. Corrected serum calcium was calculated for the cases. Tests of correlation was carried out to see if there was any relationship between corrected or total serum calcium and serum albumin.Results: The mean total serum calcium and serum corrected calcium levels in the cases was 2.04±0.34 mmol/l and 2.5 mmol/l respectively. The mean total serum calcium was 2.12±0.32 mmol/l for the controls. The mean serum albumin level was 14.7±4.1 g/l and 34.6±2.7 mmol/l for the cases and controls respectively. A negative and weak correlation was found between serum albumin and corrected serum calcium and a similar negative correlation between serum albumin and total serum calcium.Conclusions: The common reports of a positive correlation between serum ionized calcium and serum albumin cannot be applied to total or corrected serum calcium and serum albumin.

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