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Licensed Unlicensed Requires Authentication Published by De Gruyter June 2, 2015

Considerations in parathyroid hormone testing

  • Etienne Cavalier EMAIL logo , Mario Plebani , Pierre Delanaye and Jean-Claude Souberbielle

Abstract

Parathyroid hormone (PTH) is a major player in phosphocalcic metabolism and its measurement is very important for the correct diagnosis and treatment of several diseases. PTH determination represents the paradigm of quality in laboratory medicine as many variables in the pre-, intra-, and post-analytical phases strongly affect the value of the clinical information. Analytical determination of PTH has been rendered difficult by the presence, in the circulation, of truncated fragments that can cross-react with the antibodies used for its determination. In addition, pre-analytical phase is complicated by the lack of stability of the peptide and the best sample to use for its determination remains controversial, as well as sample handling and storage. PTH secretion is also affected by circadian and seasonal rhythms and by physical exercise. Finally, from the post-analytical perspective, establishment of reliable reference ranges requires further efforts as the selection criteria for reference subjects should take into consideration new variables such as gender, race and vitamin D levels. Finally, clinical guidelines have recently revised and improved the criteria for a correct interpretation of PTH values.


Corresponding author: Prof. Etienne Cavalier, Department of Clinical Chemistry, University of Liège, CHU Sart-Tilman, 4000 Liège, Belgium, Phone: +32 4 3667692, Fax: +32 4 3667691, E-mail:

Author contributions:All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Financial support: None declared.

Employment or leadership:None declared.

Honorarium: None declared.

Competing interests:The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2015-4-1
Accepted: 2015-5-4
Published Online: 2015-6-2
Published in Print: 2015-11-1

©2015 by De Gruyter

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