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Hypercalcaemia - Management
How should I interpret parathyroid hormone levels?
- Check with the local biochemistry laboratory for the reference range of normal values for parathyroid hormone (PTH), as it depends on the analytical method used.
- In the context of hypercalcaemia:
- If the PTH level is high, the most likely diagnosis is primary hyperparathyroidism. Other possible diagnoses are familial hypocalciuric hypercalcaemia and tertiary hyperparathyroidism.
- If the PTH levels is within the reference range, primary hyperparathyroidism remains a likely diagnosis, but other causes (including cancer) must be excluded.
- If PTH levels is low or undetectable, the most likely diagnosis is cancer. Other possible causes include drugs, granulomatous disease (for example sarcoidosis or tuberculosis), immobilization (in people with Paget's disease), or non-parathyroid endocrine disease.
- Be aware that primary hyperparathyroidism may coexist with cancer, resulting in PTH levels that are normal or elevated despite cancer being present.
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