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Preanalytical mystery: falsely elevated intact parathyroid hormone due to sampling from a grafted forearm

Yu-Wei Tseng1, Chun-Chieh Yeh2, Che-Yi Chou3

  • 1Division of Laboratory Medicine, Asia University Hospital, Asia University, Taichung, Taiwan.

Biochemia Medica
|October 17, 2025
PubMed

Spurious elevations in intact parathyroid hormone (iPTH) can lead to unnecessary interventions. We describe a dialysis patient who developed unexpectedly high iPTH concentrations months after total parathyroidectomy with forearm autotransplantation (TPTX-AT). Blood samples had been collected from the grafted forearm, resulting in falsely elevated iPTH values. Once the sample was collected from the non-grafted arm, iPTH concentrations normalized. This case highlights the importance of sampling site awareness in laboratory diagnostics and demonstrates how implementing a simple laboratory information system (LIS)-based protocol can prevent misinterpretation.

Keywords:
case reportiPTH, sampling siteparathyroid autotransplantationpreanalytical error

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