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Stones: Diagnosis and Evaluation
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====<span style="color:#ff0000">Parathyroid hormone (PTH)</span>==== *'''<span style="color:#ff0000">Indicated as part of the screening evaluation if primary hyperparathyroidism is suspected</span>''' **'''<span style="color:#ff0000">Primary hyperparathyroidism should be suspected when (3):</span>''' **#Mid-range PTH despite '''<span style="color:#ff0000">high or high normal serum calcium</span>''' **#'''<span style="color:#ff0000">Increased urinary calcium</span>''' **#'''<span style="color:#ff0000">Predominantly calcium phosphate stone composition</span>''' *'''Measurement of vitamin D levels may be helpful as''' '''low vitamin D levels may mask primary hyperparathyroidism, or contribute to secondary hyperparathyroidism.''' *A high or high normal intact PTH in these settings should prompt further endocrine evaluation, imaging or referral for consideration of parathyroidectomy.
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