The Use of Dynamic Functional Tests in the Clinical Evaluation of Parathyroid Disorders.

The remarkable diagnostic difficulty in the parathyroid disorders has induced many authors to study tests of dynamic investigation of this gland in order to detect functional changes. The most widely employed dynamic investigation tests of the parathyroid may be schematically considered as divided into: stimulation tests , inhibition tests and calcium turnover determination tests. The prednisone test (De Seze et al ., 1961), the mannitol test (Fourman et al., 1960), the calciferol test and the parathormone test (Ellsworth and Howard, 1934) are not widely used in the chemical practice, because of the limited value of the information which can be obtained through them. The assay of parathormone is of high importance , but its application in the clinical practice has been restricted because of the technical difficulties involved (Davies, 1958). The authors have, therefore, limited this study to the investigation of parathyroid stimulation and inhibition tests, as well as of the test based on the determination of calcium turnover. The authors will refer their considerations on the above tests, based on their clinical experience resulting from the study of over 40 cases (Ghiringhelli et al., 1963a; Ghiringhelli et al., 1963b; Ghiringhelli and Respighi, 1963c). As typical example, the authors will report the results obtained with 3 patients, affected alterations of parathyroid: 2 of these patients , affected by hypoparathyroidism, were characterized by a tetanic syndrome , which, in one of the cases, was generated after a thyroidectomy. The hypoparathyroid patient was affected by parathyroid adenoma.