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John C. Babka, MD; Roger H. Bower, MD; Jonas Sode, MD

Arch Intern Med. 1976;136(10):1140-1144.

Abstract
The clinical utility of urinary cyclic adenosine-3', 5'-monophosphate (cAMP) determinations has been limited by the overlap between hyperparathyroid and normal patients. We evaluated the potential of the parathyroid hormone (PTH)-dependent, nephrogenous cAMP in the diagnosis of hyperparathyroidism. Twenty-three patients with primary hyperparathyroidism and 19 control subjects had two-hour urine collections and blood sampling at midpoint. Nephrogenous cAMP level was calculated as total urinary cAMP excretion minus the amount filtered.

The total urinary cAMP excretion (micromols per gram of creatinine) was higher in hyperparathyroid patients (6.8 ±.5 SE), but overlapped with values obtained in controls (2.9 ±.15). The level of nephrogenous cAMP (percent of total) was also higher in hyperparathyroid patients (72.5 ± 1.8) than controls (26.3 ± 4.1) and clearly separated the groups. Determination of nephrogenous cAMP levels may be useful in the diagnosis of hyperparathyroidism.

(Arch Intern Med 136:1140-1144, 1976)

Author Affiliations
From the Division of Endocrinology-Metabolism, Department of Internal Medicine, National Naval Medical Center, Bethesda, Md. Dr Babka is now at the Naval Regional Medical Center, Camp LeJeune, NC.

Footnotes
Received for publication July 14, 1975; accepted March 7, 1976.

Read in part before the 56th annual meeting of the Endocrine Society, Atlanta, June 14, 1974.

The opinions expressed herein are those of the authors and cannot be construed as reflecting the views of the Navy Department or of the Naval Service at large.

Reprint requests to Naval Regional Medical Center, Camp LeJeune, NC 28542 (Dr Babka).

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