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Differential diagnosis of hypercalcemia. PTH is an 84-amino acid peptide hormone that is responsible for the regulation of serum calcium levels within a narrow range.
PTH is secreted in response to decrease in serum calcium levels by increasing the renal reabsorption of calcium and lowering reabsorption of phosphorus. The measurement of PTH is a useful tool in the differential diagnosis and management of hypercalcemia. PTH assays can be of help in the diagnosis of tumors and hyperplasia of the parathyroid gland, as well as in localizing hyperfunctioning parathyroid tissue by assay of samples obtained via venous catheterization. The native or intact (1-84) PTH has a short half-life, measured in minutes, whereas the carboxy and midmolecule fragments, which are biologically inactive, have half-lives 10- to 20-fold higher. The high concentrations of biologically inactive fragments have interfered with use of C-terminal or midmolecule assays for evaluation of parathyroid function in patients with impaired renal function. Intact PTH assays provide a more accurate assessment of parathyroid patients including those with various renal diseases.
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