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Parathyroid hormone dynamics in hypoparathyroidism and primary hyperparathyroidism

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Abstract

Normal pattern of parathyroid response to subsequent induction of calcium lowering and raising has been shown in most patients with surgical hypoparathyroidism and in patients with primary hyperparathyroidism. The relationship of S-PTH to B-Ca2+ showed in hypoparathyroid patients with residual PTSH_capacity, an inverse sigmoidal relationship, displaced downwards and to the left, as compared with controls. Whereas, the curve of untreated patients with primary hyperparathyroidism was displaced upwards and to the right, exhibiting significantly raised values for PTH maximum, PTH minimum and Brown's calcium set-point, Furthermore, the slope of the sigmoidal curve in patients with primary hyperparathyroidism was significantly less than in normal humans, which may reflect a reduced sensitivity of parathyroid adenomas to B-Ca2+. The calcium set-points are raised in primary hyperparathyroidism and return to normal following parathyroidectomy. The values for Brown's and Parfitt's calcium set-points are significantly different, but strikingly well correlated, supporting the view that Brown and Parfitt describe two different points on the same sigmoidal curve, corresponding to 50% and about 85% inhibition of PTH maximum, respectively.

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Authors and Affiliations

  1. Mineral Metabolic, Research Group Department of Clinical Chemistry, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark

    Peter Schwarz MD & Jesper C. Madsen

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  1. Peter Schwarz MD
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  2. Jesper C. Madsen
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Schwarz, P., Madsen, J.C. Parathyroid hormone dynamics in hypoparathyroidism and primary hyperparathyroidism. J Bone Miner Metab 12 (Suppl 1), S75–S79 (1994). https://doi.org/10.1007/BF02375680

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  • DOI: https://doi.org/10.1007/BF02375680

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