Parathyroid hormone (PTH) test

The parathyroid hormone (PTH) test (Ellsoworth-Howard test) was performed by intramuscular or intravenous injection of PTH. In primary hyperparathyroidism, there was no significant increase in cAMP and inorganic phosphorus levels. At the time of hypothyroidism, the ratio of urinary cAMP and phosphate excretion and urinary phosphorus/creatinine creatinine increased significantly, up to 10 times. There was no change in urinary phosphate increase during pseudohypothyroidism. Basic Information Specialist classification: growth and development check classification: endocrine examination Applicable gender: whether men and women apply fasting: fasting Reminder: Requirements for inspection: Actively cooperate with the doctor's request. Reactions such as nausea, vomiting, or allergies may occur after PTH injection. This test has a certain false positive and needs to be combined with clinical judgment. Normal value (1) The amino terminus is 8 to 24 ng/L, and the hydroxyl end is 50 to 330 ng/L. (2) The amount of phosphate excretion in the urine after injection of PTH in normal people, the ratio of urinary cAMP and urinary phosphorus/quiet and creatinine increased by one time compared with the basic value. Clinical significance Abnormal results: Reduce hypoparathyroidism. If the plasma PTH level is lower than the normal value, and the diagnosis of hypoparathyroidism cannot be made, it should be comprehensively analyzed in combination with other clinical conditions. Parathyroidectomy can cause hypoparathyroidism. This reduction may be temporary if the immunoassay detects PTH in serum. Increase plasma PTH levels are normal or slightly higher. If the patient has both hypocalcemia and hyperphosphatemia, consider a pseudo thyroid. Parathyroidism is low. The pathogenesis of the disease is that the target organ (bone or kidney) has a low or no response to PTH. Plasma PTH is significantly higher than normal, and elevated serum calcium concentration can not inhibit the secretion of parathyroid hormone, which may be hyperactive in the primary parathyroid gland. Ectopic hyperparathyroid hormone may be secreted by other ectopic tumors other than the parathyroid gland. PTH is elevated in kidney cancer and bronchial carcinoma, but it is not affected by blood calcium concentration. Secondary hyperparathyroidism can hyperactive chronic kidney disease, the concentration of which reaches the upper limit of normal value 10 times, and the pseudo-parathyroid function is reduced. After the third stage of parathyroid function can be hyperthyroidism, long-term secondary hyperparathyroidism may occur, and there may be autonomous hyperparathyroidism. The people who need to be examined: suspected parathyroid dysfunction, hyperparathyroidism, pseudohypoparathyroidism and other related symptoms. Precautions Forbidden before examination: Allergy test should be done before intravenous drip, hormone and saline should be diluted 1:10, and 0.1ml subcutaneous injection should be taken. Requirements for inspection: Actively cooperate with the doctor's request. Reactions such as nausea, vomiting, or allergies may occur after PTH injection. This test has a certain false positive and needs to be combined with clinical judgment. Inspection process method: 1 The patient was given a low-phosphorus diet for 5 days before the test. 2 Urine was collected from 8:00 am on the 1st day before the test, and 1 specimen per hour was used for 4 times. Base cAMP and inorganic phosphorus levels were measured. 3 At 8 o'clock on the test day, muscle or intravenous PTH200U ~ 400U for not less than 10 minutes, can also be added intravenous saline for 1 hour. Urine was collected every 30 minutes from 9:00, and a total of 4 samples were taken to measure cAMP and inorganic phosphorus. Blood samples can also be examined for blood cAMP at 1, 2, and 4 hours after the drug is taken. Not suitable for the crowd Inappropriate crowd: temporarily unknown. Adverse reactions and risks There are no related complications and hazards.

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