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Edward A. Hanna, MD, F.A.C.S.
Houston

JAMA. 1970;212(9):1527.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

In a patient with proven hyperparathyroidism, who demonstrated normocalcemia for a 12-month period (210:2063, 1969), repeated total serum calcium values were within the normal range of the reporting laboratory: 8.8 to 11.0 per 100 ml. Though hypercalcemia is considered to be the most constant finding in primary hyperparathyroidism, a few cases have been reported showing a normal serum calcium level. In 1935, McLean and Hastings suggested that ionized serum calcium value increases in hyperparathyroidism. Subsequent reports have indicated that ionized serum calcium level is elevated in cases of primary hyperparathyroidism even though the total serum calcium level may be normal. Ionized serum calcium level can be determined by biological techniques. When it is estimated from the nomogram described by McLean and Hastings, however, 14 out of 35 patients with proven primary hyperparathyroidism had ionized calcium levels within the normal range.

Total serum calcium is a composite . . . [Full Text PDF of this Article]

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