The full content of Annals is available to subscribers

Subscribe/Learn More  >
Diagnosis and Treatment |

Laboratory Tests in the Diagnosis of Hyperparathyroidism in Hypercalcemic Patients

Ann Intern Med. 1968;68(1):188-202. doi:10.7326/0003-4819-68-1-188
Text Size: A A A

The results of tests of serum phosphate concentration or urine calcium or phosphate excretion, either under controlled conditions or after infusion of calcium or phosphate, were examined for their value in diagnosing primary hyperparathyroidism. The results of these tests were compared in hypercalcemic patients with primary hyperparathyroidism, normal subjects, patients with renal stones, and patients with hypercalcemia caused by nonparathyroid tumors. Published data and our own experience demonstrate that these tests are all insensitive and nonspecific for the diagnosis of primary hyperparathyroidism.

Patients with hypercalcemia should be examined for all possible causes of hypercalcemia, and when none can be identified a diagnosis of primary hyperparathyroidism should be considered. Unfortunately, none of the tests we have discussed will confirm the diagnosis of primary hyperparathyroidism. The most difficult cases to identify are those of hypercalcemia caused by primary hyperparathyroidism and nonparathyroid malignant neoplasms without demonstrable bony metastases. In the latter patients the clinical and laboratory findings may be indistinguishable from those of patients with primary hyperparathyroidism. In hypercalcemic patients in whom primary hyperparathyroidism is suspected the decisions of whether to perform a parathyroid exploration should be based primarily on the signs, symptoms, and prognosis of the particular patient rather than on the results of any of the tests analyzed in this report.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.