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Parathyroid Hormone Radioimmunoassays in the Differential Diagnosis of Hypercalcemia Due to Primary Hyperparathyroidism or Malignancy

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▸Requests for reprints should be addressed to Edward G. Lufkin, M.D.; Mayo Clinic, West 18B; Rochester, MN 55905.

Mayo Clinic and Mayo Foundation; Rochester, Minnesota

Ann Intern Med. 1987;106(4):559-560. doi:10.7326/0003-4819-106-4-559
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The determination of serum immunoreactive parathyroid hormone (iPTH) levels remains the most useful laboratory study in the differential diagnosis of hypercalcemia. The iPTH assay has been particularly valuable in distinguishing the two commonest hypercalcemic disorders, primary hyperparathyroidism and malignancy, which together account for more than 80% of cases of persistent hypercalcemia (1-3). The importance of distinguishing these two disorders lies in the great differences in their treatment and prognosis.

There are differences in predictive value among commercially available iPTH assays, and some confusion persists concerning the terms used to describe these assays. When Raisz and coworkers (4) submitted aliquots of


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