Estimating Aberrant Homeostasis: Variance in Serum Calcium Concentration as an Aid in Diagnosis of Hyperparathyroidism

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Abstract
Frank hypercalcemia is diagnostic of hyperparathyroidism; borderline values present a diagnostic dilemma. Serum calcium and phosphorus concentrations were measured on three or more days in three groups of subjects: 13 healthy controls, 13 hyperparathyroid patients, and six recurrent oxalate stone-formers with idiopathic hypercalciuria. Variances in the concentration of each ion for all individuals were compared by a rank-order runs test. Only individual variances in serum calcium concentrations of patients with hyperparathyroidism were significantly greater than individual variances in the other two groups. Excessive day-to-day variance in serum calcium seems to reflect autonomy of parathyroid function, and can be used to help detect hyperparathyroidism. A similar approach may be diagnostically useful in other diseases in which homeostatic feedback control is aberrant.

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