Parathyroid Hormone-related Peptide
Parathyroid Hormone-related Peptide
    
Number
140194
CPT
83519
Synonyms
PTH-Related Peptide (PTH-rP)
Special Instructions
Contact LabCorp supply department for collection kit and frozen transport tube with cap.
Specimen
Plasma with Trasylol®, frozen
Volume
1 mL
Minimum Volume
0.4 mL (Note: This volume does not allow for repeat testing.)
Container
Lavender-top (EDTA) tube, chilled
CollectionCollection - Updated July 31 2007
Collect 6 mL blood into chilled lavender-top (EDTA) tube. Add 0.25 mL Trasylol® [aprotinin (10,000 KIU/mL)], or obtain a Trasylol® collection kit (LabCorp ID 33328), which contains EDTA tubes with Trasylol®. Follow the instructions with the kit. Mix specimen well, centrifuge, and transfer the plasma into a LabCorp PP transpak frozen purple tube with screw cap (LabCorp ID 49482). The specimen should be frozen immediately and maintained frozen until tested. Send specimen frozen. To avoid delays in turnaround time when requesting multiple test on frozen samples, please submit separate frozen specimen for each test requested.
Storage Instructions
Freeze
Causes for Rejection
Thawed specimen; serum specimen collected without protease inhibitor; recently administered isotopes
Reference Interval
0.0-1.5 pmol/L
Use
PTH-related peptide (PTHrP) is the principle mediator of humoral hypercalcemia of malignancy. This protein occurs in three isoforms of 139, 141, and 173 amino acids in length. The first 139 N-terminal amino acids of these isoforms are identical. The first fifteen N-terminal amino acids are similar to those of intact PTH, causing PTHrP to bind to PTH receptors and mimic the action of PTH. PTHrP production results in hypercalcemia and hypophosphatemia. PTH-rP has been found to be elevated in 50% to 90% of patients with hypercalcemia of malignancy.
Limitations
Serum PTHrP levels can be transiently elevated during pregnancy, particularly during the third trimester, due to production of PTHrP by the fetoplacental unit.1

This procedure may be considered by Medicare and other carriers as investigational and, therefore, may not be payable as a covered benefit for patients.

Methodology
Immunoradiometric assay (IRMA)
Footnotes
  1. Hirota Y, Anai T, and Miyakawa I, “Parathyroid Hormone-Related Protein Levels in Maternal and Cord Blood,” Am J Obstet Gynecol, 1997, 177(3):702-6
References

Bilezikian JP, “Measurement of Parathyroid-Related Peptide in the Circulation,” Trends Endo Metab, 1991, 2:1.

Endres DB and Rude RK, “Mineral and Bone Metabolism,” Tietz Textbook of Clinical Chemistry, 3rd ed, Burtis CA and Ashwood ER, eds, Philadelphia, PA: WB Saunders Co, 1999, 1395-457.


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