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Absence of hyperparathyroidism in severe liver disease

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Summary

Elevated serum levels of intact parathyroid hormone (PTH) have been reported in severe versus mild biliary cirrhosis. The aim of this study was to determine whether hyperparathyroidism was present in severe liver disease on the basis of the inability of the liver to catabolize the hormone. Because biologic activity resides in the amino terminal, and amino terminal PTH determinations have not been routinely made in liver disease, it is possible that hyperparathyroidism was previously missed in these patients. Accordingly, we obtained fasting blood from 11 patients with severe liver disease and 8 age-matched controls. We measured intact, amino terminal, and mid-region PTH, vitamin D metabolites, bone gamma carboxyglutamic acid protein (BGP), ionized calcium, phosphorus, magnesium, and liver function tests. Serum levels of PTH were normal with all assays and 1,25(OH)2D levels were not elevated. These findings argue against the possibility that hyperparathyroidism plays a role in the pathogenesis of hepatic osteodystrophy.

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Authors and Affiliations

  1. Department of Pediatrics, U.C.L.A. School of Medicine, Los Angeles, California, USA

    Gordon L. Klein M.D. & William E. Berquist

  2. Department of Medicine, U.C.L.A. School of Medicine, Los Angeles, California, USA

    Leonard I. Goldstein

  3. Department of Surgery, U.C.L.A. School of Medicine, Los Angeles, California, USA

    John D. Colonna II & Ronald W. Busuttil

  4. Department of Pathology, University of Southern California School of Medicine, Los Angeles, California, USA

    David B. Endres

  5. Medical and Research Services, VA Medical Center and University of California, San Diego School of Medicine, La Jolla, California, USA

    Leonard J. Deftos

Authors
  1. Gordon L. Klein M.D.
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  2. David B. Endres
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  3. John D. Colonna II
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  4. William E. Berquist
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  5. Leonard I. Goldstein
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  6. Ronald W. Busuttil
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  7. Leonard J. Deftos
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Klein, G.L., Endres, D.B., Colonna, J.D. et al. Absence of hyperparathyroidism in severe liver disease. Calcif Tissue Int 44, 330–334 (1989). https://doi.org/10.1007/BF02556312

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  • DOI: https://doi.org/10.1007/BF02556312

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