Abstract
Brandi ML, Bilezikian JP, Shoback D, et al.
J Clin Endocrinol Metab 2016 [Epub ahead of print]
The March edition of the JCEM included a series of four notable articles highlighting the presentation, diagnosis, management and epidemiology of hypoparathyroidism. Following the recently published European Society of Endocrinology clinical guidelines, these constitute the consensus guidelines from the first International Conference on the Management of Hypoparathyroidism.
Of the four articles, the Epidemiology and Diagnosis statement paper may be of particular interest to the clinical biochemistry laboratory and discusses the use of particular PTH assays. It advocates the use of second- and third-generation PTH assays (specific for the PTH carboxy- and amino-terminals, respectively) for the diagnosis of hypoparathyroidism. This point has, to my knowledge, not been mentioned in previous guidelines. Interestingly, this paper suggests that the third-generation assays, while theoretically better, have not proven superior in clinical practice. The paper mentions a recent report (J Bone Miner Res 2015; 30: 1803–1813) describing the influence of genetic mutations on the diagnostic performance of the second- and third-generation assays.
In summary, this series of papers addresses key aspects of diagnosis, evaluation and management of hypoparathyroidism.