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Research Article Free access | 10.1172/JCI106701

Immunologic differentiation of primary hyperparathyroidism from hyperparathyroidism due to nonparathyroid cancer

B. Lawrence Riggs, Claude D. Arnaud, James C. Reynolds, and Lynwood H. Smith

Mayo Clinic and Mayo Foundation: Division of Endocrinology and Internal Medicine, University of Minnesota, Rochester, Minnesota 55901

Department of Endocrine Research, University of Minnesota, Rochester, Minnesota 55901

Division of Nephrology and Internal Medicine, University of Minnesota, Rochester, Minnesota 55901

Mayo Graduate School of Medicine, University of Minnesota, Rochester, Minnesota 55901

Find articles by Riggs, B. in: PubMed | Google Scholar

Mayo Clinic and Mayo Foundation: Division of Endocrinology and Internal Medicine, University of Minnesota, Rochester, Minnesota 55901

Department of Endocrine Research, University of Minnesota, Rochester, Minnesota 55901

Division of Nephrology and Internal Medicine, University of Minnesota, Rochester, Minnesota 55901

Mayo Graduate School of Medicine, University of Minnesota, Rochester, Minnesota 55901

Find articles by Arnaud, C. in: PubMed | Google Scholar

Mayo Clinic and Mayo Foundation: Division of Endocrinology and Internal Medicine, University of Minnesota, Rochester, Minnesota 55901

Department of Endocrine Research, University of Minnesota, Rochester, Minnesota 55901

Division of Nephrology and Internal Medicine, University of Minnesota, Rochester, Minnesota 55901

Mayo Graduate School of Medicine, University of Minnesota, Rochester, Minnesota 55901

Find articles by Reynolds, J. in: PubMed | Google Scholar

Mayo Clinic and Mayo Foundation: Division of Endocrinology and Internal Medicine, University of Minnesota, Rochester, Minnesota 55901

Department of Endocrine Research, University of Minnesota, Rochester, Minnesota 55901

Division of Nephrology and Internal Medicine, University of Minnesota, Rochester, Minnesota 55901

Mayo Graduate School of Medicine, University of Minnesota, Rochester, Minnesota 55901

Find articles by Smith, L. in: PubMed | Google Scholar

Published October 1, 1971 - More info

Published in Volume 50, Issue 10 on October 1, 1971
J Clin Invest. 1971;50(10):2079–2083. https://doi.org/10.1172/JCI106701.
© 1971 The American Society for Clinical Investigation
Published October 1, 1971 - Version history
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Abstract

Serum immunoreactive parathyroid hormone (IPTH) was measured by radioimmunoassay in 54 patients with primary hyperparathyroidism and in 18 consecutive patients with ectopic hyperparathyroidism due to nonparathyroid cancer without apparent skeletal metastasis. Although serum calcium concentration was higher in the group with ectopic hyperparathyroidism, serum IPTH was lower (rank sum test, P < 0.001) and was undetectable in eight. A second anti-PTH antiserum also differentiated between IPTH in the two groups, although IPTH was undetectable in only 1 of 14 sera. When IPTH values in serial dilutions were plotted, slopes for the two patients with ectopic hyperparathyroidism who had relatively high IPTH were less (P < 0.001) than slopes for standard hyperparathyroid sera. By using differences in either IPTH rank or slope of the dilutional curve of sera, primary hyperparathyroidism could be excluded as a cause of the hypercalcemia in 16 of the 18 patients with ectopic hyperparathyroidism. The data are interpreted as indicating that PTH-like material in the serum of these patients with ectopic hyperparathyroidism is immunologically different from the PTH in the serum of patients with primary hyperparathyroidism.

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