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January 8, 1973, Vol 223, No. 2 >
ARTICLE | January 8, 1973

Ionic Calcium Determination in Primary Hyperparathyroidism FREE

James C. Low, MD; Marcus Schaaf, MD; Jerry M. Earll, MD; Joseph T. Piechocki; Ting-Kai Li, MD
[+] Author Affiliations

Read in part before the National Meeting of the American Federation of Clinical Research, Atlantic City, NJ, May 1, 1971.

Reprint requests to Department of Endocrinology & Metabolism, Walter Reed Army Institute of Research, Washington, DC 20012 (Dr. Low).


JAMA. 1973;223(2):152-155. doi:10.1001/jama.1973.03220020022005
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References

Serum ionic and total calcium levels were measured in 15 patients with clinical diagnosis of primary hyperparathyroidism. Ionic calcium level was measured by a calcium-selective liquid-membrane electrode and total calcium level was measured by atomic absorption spectroscopy.

Concurrent determinations of ionic and total calcium in 230 blood donors served as normal values. Of the determinations of ionic calcium in the hyperparathyroid patients, 98.5% (67 of 68) fell outside the normal range of 4.48 to 5.28 mg/100 ml, while 77% (57 of 74) of the determinations of total calcium in the same patients was outside the normal range of 8.3 to 10.1 mg/100 ml. Parathyroid adenomas or hyperplasia were found in 14 of 15 patients. The calcium-selective electrode has proven to be highly discriminatory in separating hypercalcemia from normocalcemia in patients with primary hyperparathyroidism.

REFERENCES

1 +
Ross JW:  Calcium-selective electrode with liquid ion exchanger . Science 156:1378-1379, 1967;.
2 +
Li TK, Piechocki JT:  Determination of serum ionic calcium with the ion-selective electrode: Evaluation of methodology and normal values . Clin Chem 17:411-416, 1971;.
3 +
Trudeau DL, Freier EF:  Determination of calcium in urine and serum by atomic absorption spectrophotometry . Clin Chem 13:101-114, 1967;.
4 +
McLean FC, Hastings AB:  A biological method for the estimation of calcium-ion concentration . J Biol Chem 107:337-350, 1934;.
5 +
Ettori J, Scoggan SM:  A determination of ionized calcium in serum by two wavelength spectrophotometry of a metal indicator . Clin Chim Acta 6:861-865, 1961;.
6 +
Frizel DE, Malleson AG, Marks V:  Measurement of plasma ionized calcium and magnesium by ion exchange strip . Clin Chim Acta 16:45-56, 1967;.
7 +
Rose GA:  Determination of the ionized and ultrafilterable calcium of normal human plasma . Clin Chim Acta 2:227-236, 1957;.
8 +
Hattner RS, et al:  Electrochemical determination of apparent ionized serum calcium using a calcium-selective electrode . Clin Chim Acta 28:67-75, 1970;.
9 +
Moore EW:  Studies with ion-exchange calcium electrodes: Some applications in biomedical research and clinical medicine , in Durst R (ed): Symposium on Ion-Exchange Electrodes, January 1969 . National Bureau of Standards, special publication 314, 1969;.
10 +
Oreskes I, et al:  Measurement of ionized calcium in human plasma with a calcium selective electrode . Clin Chim Acta 21:303-313, 1968;.
11 +
Raman A:  Determination of ionized calcium in serum with a calcium electrode . Biochem Med 3:369-375, 1970;.
12 +
Sachs C, Bourdeau AM, Balsan S:  Determination du calcium ionise dans le serum avec une electrode specifique a membrane liquide . Ann Biol Clin 27:487-510, 1969;.
13 +
Dawkins RL, Moore EW:  A case of hyperparathyroidism with serial determinations of ionized calcium . Clin Res 17:283, 1969;.
14 +
Hansen SO, Theodorsen L:  The usefulness of an improved calcium electrode in the measurement of ionized calcium in serum . Clin Chim Acta 31:119-122, 1971;.
15 +
Schwartz HD, McConville BC, Christopherson EF:  Serum ionized calcium by specific ion electrode . Clin Chim Acta 31:97-107, 1971;.
16 +
Lindgarde F, Zettervall O:  Serum ionized calcium in a normal population studied with a calcium ion-sensitive electrode . Isr J Med Sci 7:510-513, 1971;.
17 +
Seamonds B, Towfighi J, Arvan DA:  Determination of ionized calcium in serum by use of an ion-selective electrode . Clin Chem 18:155-160, 1972;.
18 +
Wills MR, McGowan GK:  Plasma chloride levels in hyperparathyroidism and other hypercalcemic states . Br Med J 1:1153-1156, 1964;.
19 +
Barzel US:  Parathyroid hormone, blood phosphorus, and acid-base metabolism . Lancet 1:1329-1331, 1971;.
20 +
Muldowney FP, et al:  Correction of renal bicarbonate wastage by parathyroidectomy . Q J Med 40:487-498, 1971;.

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1 +
Ross JW:  Calcium-selective electrode with liquid ion exchanger . Science 156:1378-1379, 1967;.
2 +
Li TK, Piechocki JT:  Determination of serum ionic calcium with the ion-selective electrode: Evaluation of methodology and normal values . Clin Chem 17:411-416, 1971;.
3 +
Trudeau DL, Freier EF:  Determination of calcium in urine and serum by atomic absorption spectrophotometry . Clin Chem 13:101-114, 1967;.
4 +
McLean FC, Hastings AB:  A biological method for the estimation of calcium-ion concentration . J Biol Chem 107:337-350, 1934;.
5 +
Ettori J, Scoggan SM:  A determination of ionized calcium in serum by two wavelength spectrophotometry of a metal indicator . Clin Chim Acta 6:861-865, 1961;.
6 +
Frizel DE, Malleson AG, Marks V:  Measurement of plasma ionized calcium and magnesium by ion exchange strip . Clin Chim Acta 16:45-56, 1967;.
7 +
Rose GA:  Determination of the ionized and ultrafilterable calcium of normal human plasma . Clin Chim Acta 2:227-236, 1957;.
8 +
Hattner RS, et al:  Electrochemical determination of apparent ionized serum calcium using a calcium-selective electrode . Clin Chim Acta 28:67-75, 1970;.
9 +
Moore EW:  Studies with ion-exchange calcium electrodes: Some applications in biomedical research and clinical medicine , in Durst R (ed): Symposium on Ion-Exchange Electrodes, January 1969 . National Bureau of Standards, special publication 314, 1969;.
10 +
Oreskes I, et al:  Measurement of ionized calcium in human plasma with a calcium selective electrode . Clin Chim Acta 21:303-313, 1968;.
11 +
Raman A:  Determination of ionized calcium in serum with a calcium electrode . Biochem Med 3:369-375, 1970;.
12 +
Sachs C, Bourdeau AM, Balsan S:  Determination du calcium ionise dans le serum avec une electrode specifique a membrane liquide . Ann Biol Clin 27:487-510, 1969;.
13 +
Dawkins RL, Moore EW:  A case of hyperparathyroidism with serial determinations of ionized calcium . Clin Res 17:283, 1969;.
14 +
Hansen SO, Theodorsen L:  The usefulness of an improved calcium electrode in the measurement of ionized calcium in serum . Clin Chim Acta 31:119-122, 1971;.
15 +
Schwartz HD, McConville BC, Christopherson EF:  Serum ionized calcium by specific ion electrode . Clin Chim Acta 31:97-107, 1971;.
16 +
Lindgarde F, Zettervall O:  Serum ionized calcium in a normal population studied with a calcium ion-sensitive electrode . Isr J Med Sci 7:510-513, 1971;.
17 +
Seamonds B, Towfighi J, Arvan DA:  Determination of ionized calcium in serum by use of an ion-selective electrode . Clin Chem 18:155-160, 1972;.
18 +
Wills MR, McGowan GK:  Plasma chloride levels in hyperparathyroidism and other hypercalcemic states . Br Med J 1:1153-1156, 1964;.
19 +
Barzel US:  Parathyroid hormone, blood phosphorus, and acid-base metabolism . Lancet 1:1329-1331, 1971;.
20 +
Muldowney FP, et al:  Correction of renal bicarbonate wastage by parathyroidectomy . Q J Med 40:487-498, 1971;.

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