Mitt-C-regionales Parathormon in der klinischen Routine: Diagnostische Wertigkeit beim extrarenalen (primären) und renalen (sekundären) Hyperparathyreodismus

Summary The selective determination of mid-C-regional parathyroid hormone (mid-C-PTH) in combination with other laboratory parameters is a reliable tool for diagnosis and treatment of extrarenal (primary) and renal (secondary) hyperparathyroidism. Early stages, which show either high-to-normal serum calcium and elevated mid-C-PTH or increased serum calcium but normal mid-C-PTH, can be distinguished from overt hyperparathyroidism. Alkaline phosphatase (AP) activity and mid-C-regional PTH provide biochemical confirmation of histologically classified renal osteodystrophy. Since the index AP×PTH signifies osseous changes in dialysis patients at an early stage, therapeutic regimens may be altered without additional invasive procedures. After renal transplantation mid-C-PTH normalizes and serum creatinine decreases. Increased mid-C-PTH in patients with normal renal graft function reflects autonomous PTH secretion, which requires careful monitoring to prevent PTH-induced hypercalciuria.

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Abkürzungsverzeichnis AP Alkalische Phosphatase - Ca Gesamtcalcium - DFO Desferrioxamin - HPT Hyperparathyreodismus - Index (AP×PTH) Produkt aus Mitt-C-PTH und AP - Mitt-C-PTH Mitt-C-regionales PTH - MW Molekulargewicht - NTX Nierentransplantation - PTH Parathormon - PTX Parathyreoidektomie mit Reimplantation in den Unterarm - PO₄ Phosphat - RIA RadioimmunoassayMit Unterstützung der Deutschen Forschungsgemeinschaft (DFG) Ju 177/1-1