The Calcium Loading Test in Primary Hyperparathyroidism – Does it Provide Useful Information?

Q4 Medicine

Acta Medica Bulgarica Pub Date : 2022-10-01 DOI:10.2478/amb-2022-0023

D. Bakalov, M. Boyanov, Prof. Mihail Boyanov

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引用次数: 0

Abstract

Abstract Objective: to describe the results from intravenous calcium loads in patients with suspected PHPT. Methods: This was a retrospective cross-sectional study with inpatients’ data review. Baseline serum calcium, phosphates, magnesium, creatinine, alkaline phosphatase, beta-crosslinks were recorded. The calcium loading had been performed after an overnight fasting. Calcium gluconate 0.25 mmol/kg body weight (10 mg/kg) dissolved in 0.9% Sodium Chloride was infused intravenously for 3 hours. Blood samples for total serum calcium, phosphates and iPTH were drawn before and up to 60 minutes after the calcium load. The intact parathyroid hormone (iPTH) and 25(OH)-vitamin D were determined by electro-hemi-luminescence (Elecsys, Roche Diagnostics). The PTH inhibition rate in % (PTH-IR), the calcium increment, the ratio R (ΔPTH/ΔCalcium) and the product P (calcium X PTH at test end) were calculated. Results: 23 patients with PHPT had complete data from calcium loading tests. The PTH suppression was < 30% in 17.4% of the participants, 30% to 50% – in 21.7% and > 50% in the remaining 60.9%. One patient displayed PTH suppression > 75%. The Ratio R was < 4.0 in all but one patient. Product P was above 1100 mg/dl x pg/ml in 9 participants (39.1%). Sixteen patients (69.6%) had positive localization results from US or SPECT-CT. The level of PTH suppression was not related to any parameter except the volume of the suspected lesion. Conclusion: The calcium loading test was unable to differentiate the forms of PHPT. It did not add great value in the diagnostic work-up of PHPT.

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原发性甲状旁腺功能亢进症的钙负荷试验——它能提供有用的信息吗？

摘要目的：描述疑似PHPT患者静脉内钙负荷的结果。方法：这是一项回顾性横断面研究，对住院患者的数据进行回顾。记录基线血清钙、磷酸盐、镁、肌酸酐、碱性磷酸酶、β交联。钙负荷是在禁食过夜后进行的。将溶解在0.9%氯化钠中的葡萄糖酸钙0.25mmol/kg体重（10mg/kg）静脉内输注3小时。在钙负荷之前和之后直到60分钟抽取血清总钙、磷酸盐和iPTH的血样。完整的甲状旁腺激素（iPTH）和25（OH）-维生素D通过电化学发光（Elecsys，Roche Diagnostics）测定。计算PTH抑制率（%）（PTH-IR）、钙增量、比率R（ΔPTH/Δ钙）和产物P（试验结束时钙X PTH）。结果：23例PHPT患者的钙负荷试验数据完整。17.4%的参与者PTH抑制<30%，21.7%的参与者为30%-50%-，其余60.9%的参与者为>50%。一名患者显示PTH抑制>75%。除一名患者外，所有患者的比值R均<4.0。9名受试者（39.1%）的产物P高于1100 mg/dl x pg/ml。16名患者（69.6%）的US或SPECT-CT定位结果呈阳性。PTH抑制水平与任何参数无关，除了可疑病变的体积。结论：钙负荷试验不能区分PHPT的形态。它在PHPT的诊断检查中没有增加很大的价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Medica Bulgarica Medicine-Medicine (all)

CiteScore

0.30

自引率

0.00%

发文量

审稿时长

25 weeks

期刊介绍： About 30 years ago - in 1973, on the initiative of the Publishing House „Medicine and Physical Culture", namely its former director Mr. Traian Ivanov, the Ministry of Health set up and accepted to subsidize a new medical magazine that was to be published only in the English language and had to reflect the status and the achievements of the Bulgarian medical science. Thus the language barrier was overcome and stable relations were established with the international medical society, large libraries, and university centers. The famous internationally known scientist professor Assen A. Hadjiolov was elected edition-in-chief by the first editorial staff and the magazine was named Acta Medica Bulgarica.