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Differentiation of Pseudo-and Idiopathic Hypoparathyroidism by Measuring Urinary Calcitonin^*

Division of Bone and Mineral Metabolism, Department of Medicine, The Jewish Hospital of St. Louis and Washington University School of Medicine St. Louis, Missouri 63110
The Division of Medicine and Geriatrics, Osaka University Medical School Osaka 553, Japan

Address requests for reprints to: Shigeto Morimoto, M.D., Division of Bone and Mineral Metabolism, The Jewish Hospital of St. Louis, 216 South Kingshighway, St. Louis, Missouri 63110.

Calcitonin (CT) levels were determined in urine specimens from normal subjects and patients with pseudohypoparathyroidism type I (PHP), idiopathic hypoparathyroidism (IHP), pseudopseudohypoparathyroidism (PPHP), and surgical hypoparathyroidism (SHP). Urinary CT was measured by RIA after extraction of urine by gel chromatography on a 0.8 x 20-cm column of Bio-Gel P-2. The urinary CT level ranged from 420–1000 pg/mg creatinine (Cr; mean ± SD, 631 ± 229) in PHP (n = 6), from 50–270 (131 ± 92) in IHP (n = 6), and from 35–93 (66 ± 27) in SHP (n = 6), and was 185 pg/mg Cr in one patient with PPHP. The mean value in PHP was significantly (P < 0.001) higher, and that in SHP was significantly (P < 0.05) lower, than those in the age-matched normal subjects. In each patient with PHP and IHP before and after treatment with lahydroxycholecalciferol, urinary CT levels fluctuated between 700–1370 pg/mg Cr in PHP and from 43–195 pg/mg Cr in IHP. Increased urinary excretion of CT in patients with PHP suggests that CT secretion may be enhanced in this disease. The biological role of CT in PHP remains to be clarified.

^* This work was supported by research grants from the Ministry of Education, Science, and Culture and the Ministry of Health and Welfare of Japan and in part by NIH Grant 88774.

Received February 7, 1983.