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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter

IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

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Volume 53, Issue 12


Considerations in parathyroid hormone testing

Etienne Cavalier / Mario Plebani / Pierre Delanaye
  • Department of Nephrology, Dialysis and Transplantation, University of Liège, CHU Sart-Tilman, Liège, Belgium
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Jean-Claude Souberbielle
Published Online: 2015-06-02 | DOI: https://doi.org/10.1515/cclm-2015-0314


Parathyroid hormone (PTH) is a major player in phosphocalcic metabolism and its measurement is very important for the correct diagnosis and treatment of several diseases. PTH determination represents the paradigm of quality in laboratory medicine as many variables in the pre-, intra-, and post-analytical phases strongly affect the value of the clinical information. Analytical determination of PTH has been rendered difficult by the presence, in the circulation, of truncated fragments that can cross-react with the antibodies used for its determination. In addition, pre-analytical phase is complicated by the lack of stability of the peptide and the best sample to use for its determination remains controversial, as well as sample handling and storage. PTH secretion is also affected by circadian and seasonal rhythms and by physical exercise. Finally, from the post-analytical perspective, establishment of reliable reference ranges requires further efforts as the selection criteria for reference subjects should take into consideration new variables such as gender, race and vitamin D levels. Finally, clinical guidelines have recently revised and improved the criteria for a correct interpretation of PTH values.

Keywords: calcium metabolism; clinical guidelines; diurnal and seasonal rhythms; parathyroid hormone; reference ranges; sample of choice; stability


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About the article

Corresponding author: Prof. Etienne Cavalier, Department of Clinical Chemistry, University of Liège, CHU Sart-Tilman, 4000 Liège, Belgium, Phone: +32 4 3667692, Fax: +32 4 3667691, E-mail:

Received: 2015-04-01

Accepted: 2015-05-04

Published Online: 2015-06-02

Published in Print: 2015-11-01

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 53, Issue 12, Pages 1913–1919, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2015-0314.

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