تغيير كلمة المرور

تذكرني

الجودة

وظائف

PTH should be performed

Primary hyper-parathyroidism or Familial benign hypercalcemia.
To differentiate, we determine urinary calcium which will be high in Primary hyper-parathyroidism and low in Familial benign hypercalcemia.

High PTHrP is suggestive of cancer.
Low/normal PTHrP order Vitamin D: Low results are suggestive of cancer while high values are suggestive of lymphoma or granulomatous disease (ex. Sarcoidosis).

Serum Ca > 10.3 mg/dL
↓
Order intact PTH
Low PTH			High PTH
↓			↓
Order Parathyroid Hormone-Related Peptide (PTHrP)			Primary hyper-parathyroidism or Familial benign hypercalcemia
↓	↓
High PTHrP is suggestive of cancer	Low/normal PTHrP ↓ order Vitamin D		order urinary calcium
	↓		↓	↓
	Low ↓ suggestive of cancer	High ↓ suggestive of lymphoma or granulomatous disease	High ↓ Primary hyper-parathyroidism	low ↓ Familial benign hypercalcemia

If low corrected calcium: determine intact Parathyroid hormone (PTH), creatinine (Cr), phosphorus (P) and Magnesium (Mg).

Low PTH, normal Cr, normal/high P and low Mg: Magnesium deficiency.
Low PTH, normal Cr, normal/high P and normal Mg: Hypo-parathyroidism.
Normal PTH, normal Cr, normal/low P, normal Mg and low albumin: Hypo-albuminemia
High PTH, normal Cr, Normal/low P and normal Mg: check vitamin D deficiency.
High PTH, high Cr, normal/high P and normal Mg: Renal Disease or pseudo-hypo-parathyroidism

Serum calcium < 8.2 mg/dL
↓
Order serum albumin
↓					↓
If < 4.0 g/dL					If > 4.0 g/dL
Use corrected Ca					Use result value
↓					Use result value
If still < 8.2 mg/dL					If result became normal
Order intact Parathyroid hormone (PTH) creatinine (Cr) phosphorus (P) Magnesium (Mg)					↓ hypoalbuminemia
↓	↓	↓	↓	↓
Low PTH normal Cr normal/high P normal Mg	Low PTH normal Cr normal/high P low Mg	Normal PTH normal Cr normal/low P normal Mg low albumin	High PTH normal Cr Normal/low P normal Mg	High PTH high Cr normal/high P normal Mg
↓	↓	↓	↓	↓
Hypo-parathyroidism	Magnesium deficiency	Hypo-albuminemia	check vitamin D deficiency	Renal Disease Or pseudo-hypo-parathyroidism

نبذة عامة
الرؤية والرسالة
فريق العمل - فروعنا

للحصول على آخر أخبارنا وعروضنا وتخفيضاتنا أدخل ايميلك للاشتراك في القائمة البريدية

البريد الإلكتروني *