We report the first case of hypercalcemia-induced acute pancreatitis caused by a functioning parathyroid cyst in a 67-year-old man. Laboratory investigation revealed increased serum amylase and lipase, increased serum ionized calcium and parathyroid hormone (PTH) levels, and decreased serum phosphate, indicating pancreatitis and primary hyperparathyroidism (PHPT). Abdominal computed tomography ...

The role of various parathyroid hormone (PTH) radio-immunoassays in the diagnosis of primary hyperparathyroidism (PHP) is controversial. A series of 204 patients with surgically proven PHP was studied. Serum total calcium, serum ionized calcium, amino (N)-terminal PTH and carboxyl(C)-terminal PTH were assessed in relation to the volume and weight of adenomatous or hyperplastic parathyroid tissu...

OBJECTIVE To evaluate parathyroid function and mineral metabolism in psychiatric patients users of lithium salts. MATERIALS AND METHODS We measured the serum levels of calcium, ionized calcium, inorganic phosphorus, alkaline phosphatase, albumin, parathyroid hormone (PTH), urea, creatinine, 25-hydroxy-vitamin D and lithium of 35 patients diagnosed with bipolar disorder in use of lithium carbo...

A 7-day-old male infant born to a healthy 33-year-old female at 37 weeks of gestation was brought to the local emergency department (ED) with sudden-onset tonic-clonic seizures. Laboratory testing revealed extreme hypocalcemia (ionized calcium of 3.2 mg/dl) and undetectable parathyroid hormone (PTH <10 pg/ml). Concomitant evaluation of the mother revealed both elevated ionized calcium (5.9 mg/d...

The ionized calcium concentration in blood is maintained within narrow limits by a complex hormonal system that includes parathyroid hormone (PTH) and vitamin D. The kidney plays a pivotal role in the physiologic action of PTH, as this peptide hormone increases tubular calcium reabsorption, decreases tubular phosphate reabsorption, and stimulates the renal 25-hydroxy-1-hydroxylase to convert 25...

OBJECTIVE To describe the hitherto unrecognized occurrence of transient ionized hypocalcemia with acute adrenal insufficiency and its therapy. METHODS We present three case reports with documented longitudinal laboratory findings. RESULTS Transient ionized hypocalcemia of acute illness has been noted in children and adults and is associated with increased mortality. Precipitating illnesses ...

This brief review focuses on calcium balance and homeostasis and their relationship to dietary calcium intake and calcium supplementation in healthy subjects and patients with chronic kidney disease and mineral bone disorders (CKD-MBD). Calcium balance refers to the state of the calcium body stores, primarily in bone, which are largely a function of dietary intake, intestinal absorption, renal ...

Convincing evidence demonstrates that ionized calcium and not total calcium is the physiologically relevant component of blood calcium. Direct measurement of ionized calcium, however, is limited by difficulties in accurate analysis, lack of standardization, and need for special handling, all resulting in increased cost; therefore, strategies have been developed to estimate ionized calcium from ...

Hypocalcemia is the main factor responsible for the genesis of secondary hyperparathyroidism in chronic renal disease. Studies with parathyroid cells obtained from uremic patients indicate that there is a shift in the set point for calcium-regulated hormone (parathyroid hormone [PTH] secretion. Studies were performed in dogs to further clarify this new potential mechanism. Hypocalcemia was prev...