WEBINAR: Advances in Parathyroid Hormone Testing

SPONSORED BY: DiaSorin, DiaSorin
C.E. CREDITS: P.A.C.E. CE | Florida CE
Speakers
  • Professor of Clinical Chemistry at the University of Liege and Head of the Department of Clinical Chemistry at CHU de Liege
    Biography
      Etienne Cavalier was born in Liege, Belgium in 1971. He received his Master in Pharmaceutical Sciences in 1994, his Advanced Master in Clinical Biology in 1999 and his PhD in Pharmaceutical and Biomedical Sciences in 2010 from the University of Liege. Etienne Cavalier is now Professor of Clinical Chemistry at the University of Liege and Head of the Department of Clinical Chemistry at the CHU de Liege. His main research topics are linked with the phosphocalcic metabolism, renal function, frailty and sarcopenia. Etienne Cavalier has published over 200 papers, 6 book chapters and has an h-index of 25. Professor Cavalier also serves on the Clinica Chimica ACTA's editorial board.

    Abstract:

    Parathyroid hormone (PTH) is an 84 amino acid that plays a key role in phosphocalcic metabolism. Its measurement is essential to diagnose and treat primary hyperparathyroidism and to evaluate chronic kidney disease-mineral and bone disorders (CKD-MBD).  PTH determination is not an easy task, because of the many similar fragments that circulate in our blood. Among these fragments are a group commonly called (7-84) PTH, which are truncated in the amino-terminal part of the peptide. These fragments are quite low in normal healthy subjects; they accumulate in patients with chronic kidney diseases (CKD) and can be up to 50% of the (1-84) PTH in hemodialyzed patients (HD).

    Clinical laboratories are often using “intact” PTH assays.  These assays detect the (1-84) peptide and the (7-84) PTH fragments. Because these fragments are recognized differently by the various assays, the values obtained are often very different between “intact” kits. 3rd generation PTH assays, are specific for the (1-84) PTH and do not cross-react with the (7-84) fragments, resulting in less variability.  Up to now, 3rd generation PTH assays have not demonstrated any clinical benefit over intact PTH assays.  However, PTH standardization can be achieved only with 3rd generation and it will be impossible to standardize assays using the intact PTH kits, because of variable cross-reactivities to fragments.

    It is important to carefully select the “normal” subjects to establish reference ranges that allow the proper interpretation of the patient’s PTH results. These “normals” should not have secondary hyperparathyroidism and should have eGFR, 25(OH)D, calcium and phosphorus levels within a normal range. Unfortunately, manufacturers have not judiciously selected their “normals”, leading to falsely elevated PTH reference ranges. Using correctly established PTH reference ranges will assist physicians in correctly classifying HD patients in the appropriate bone turnover category.

    Learning objectives: 

    • To understand the 2nd and 3rd generation PTH assays and their cross-reactivity to different circulating forms
    • To understand the importance of good reference range establishment for PTH
    • To understand the importance of PTH standardization
    • To get up-to-date information regarding PTH stability 

    Show Resources
    You May Also Like
    MAY 22, 2018 08:00 AM PDT
    C.E. CREDITS
    MAY 22, 2018 08:00 AM PDT
    DATE: May 22, 2018TIME: 08:00AM PDT The nuclear receptors pregnane X receptor (PXR) and constitutive androstane receptor (CAR) are closely related transcription factors that...
    AUG 15, 2018 08:00 AM PDT
    C.E. CREDITS
    AUG 15, 2018 08:00 AM PDT
    DATE: August 15, 2018TIME: 08:00AM PDT, 11:00AM EDTThe failure of current chemotherapeutic strategies in the fight against cancer can be largely attributed to the occurrence of drug res...
    JUN 26, 2018 06:00 AM PDT
    C.E. CREDITS
    JUN 26, 2018 06:00 AM PDT
    Date: June 26, 2018Time: 6:00 a.m. PDT, 9:00 a.m. EDT, 1500 CEST Today’s hematology analyzers employ various methods for enumerating platelets. These methods include: e...
    MAY 03, 2018 11:00 AM PDT
    MAY 03, 2018 11:00 AM PDT
    DATE: May 3, 2018TIME: 11:00AM PDT, 2:00PM EDTWhile stress is one of the leading causes of neuropsychiatric disorders, the molecular underpinnings of how stress induces alterations in b...
    MAY 24, 2018 09:30 AM PDT
    C.E. CREDITS
    MAY 24, 2018 09:30 AM PDT
    DATE: May 24, 2018 TIME: 9:30PM PDT The current gold standard in in vitro pre-clinical cancer treatment screening remain cell lines,...
    APR 27, 2018 10:00 AM PDT
    C.E. CREDITS
    APR 27, 2018 10:00 AM PDT
    DATE: April 27, 2018TIME: 10:00am PST, 1:00pm ESTGlioblastoma (GBM) and Medulloblastoma (MB) are the most common adult and paediatric brain tumours, both of which can have devastating c...
    Loading Comments...