Primary Hyperparathyroidism with “Normal” Parathyroid Hormone Levels

In a large cohort study, 6% of patients with primary hyperparathyroidism had PTH levels ≤50 pg/mL.

When hypercalcemia is attributed to primary hyperparathyroidism, the serum parathyroid hormone (PTH) level is occasionally within the normal range. In these cases, PTH is assumed to be “inappropriately normal,” because hypercalcemia from other causes should suppress PTH to subnormal levels.

In this single-center study, researchers used a database of 2300 patients who underwent surgery for primary hyperparathyroidism and compared those with preoperative PTH ≤50 pg/mL and >50 pg/mL. (Note: Normal PTH range is 12–88 pg/mL at this institution, but the authors chose a cutoff of 50 for this study.) The following findings were noted:

6% of patients had preoperative PTH levels ≤50 pg/mL.
Median PTH levels were 40 pg/mL and 107 pg/mL in the normal- and…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose

Primary Hyperparathyroidism with “Normal” Parathyroid Hormone Levels

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Reviewing Author