Abstract
Routine application of multichannel laboratory screening for both inpatients and outpatients has increased detection of hypercalcemia. With these improved diagnostic tools, it has become possible to distinguish true hyperparathyroidism from nonendocrine disorders of calcium metabolism. Typical features of primary and secondary hyperparathyroidism are described in relation to their clinical presentation. Diagnosis is based on laboratory findings which include repeated serum calcium and phosphate measurements as the first step, additional specific functional tests for borderline cases, and serum parathyroid hormone (PTH) measurements as pathognomonic proof of excess hormone secretion. Significance and reliability of diagnostic procedures are discussed with regard to routine and selective application.
Résumé
L'utilisation en routine du screening de laboratoire par les appareils automatiques multi-canaux, tant pour les malades hospitalisés que pour les consultants, a accru les possibilités de détection des hypercalcémies. Ces méthodes de diagnostic perfectionnées permettent de distinguer l'hyperparathyroïdie vraie des troubles du métabolisme calcique d'origine non endocrinienne. Les caractéristiques de l'hyperparathyroïdie primaire et secondaire sont décrites, ainsi que les tableaux cliniques. Le diagnostic doit être basé sur les investigations biologiques: d'abord mesures répétées de la calcémie et de la phosphorémie, tests fonctionnels spécifiques pour les cas douteux, dosage de la parathormone plasmatique comme preuve de l'hyperproduction hormonale. La signification et la valeur des moyens de diagnostic sont discutées, tant pour l'utilisation en routine que dans les cas sélectionnés.
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Supported by Deutsche Forschungsgemeinschaft (Schm 400/1).
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Roeher, H.D., Schmidt-Gayk, H. Diagnosis of primary and secondary hyperparathyroidism. World J. Surg. 1, 709–718 (1977). https://doi.org/10.1007/BF01555921
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DOI: https://doi.org/10.1007/BF01555921