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[Diagnostic methods in primary hyperparathyroidism].

Diagnostic methods of primary hyperparathyroidism were studied. The results obtained were as follows: 1. Because the serum levels of electrolytes and parathyroid hormone and the amounts of urinary electrolytes fluctuate markedly multiple determinations were necessary. 2. Judging from the mean values, the highest rate of diagnosis was obtained by serum calcium (91%), followed by serum alkaline phosphatase (72%), serum parathyroid hormone (68%) and serum phosphate (56%). A rather low rate of diagnosis was obtained by the amounts of urinary calcium (44%) and urinary phosphate (28%). 3. Calcium loading test and measurement of nephrogenous cyclic AMP were all positive in 6 and 4 cases, respectively. Urinary cyclic AMP (90%) and % tubular reabsorption of phosphate (88%) were also useful. Two cases of normocalcemic primary hyperparathyroidism were diagnosed by these tests. These results show that active testing is necessary in the case of recurrent urolithiasis whose serum calcium is high normal.