The diagnosis is usually first suspected because of the incidental finding of an elevated serum calcium concentration on biochemical screening tests.
If hypercalcemia is confirmed, intact<unk>  hormone (PTH) should be measured concomitantly with the serum calcium.<unk>  adenoma is diagnosed by finding a frankly elevated PTH concentration in a patient with hypercalcemia.
When the PTH is only minimally elevated or within the normal range,<unk>  adenoma remains the most likely diagnosis.
Patients with<unk>  adenoma typically come to medical attention in the setting of an evaluation for low bone mineral density (BMD), during which time PTH levels are drawn and found to be elevated in the absence of hypercalcemia.
In particular, all secondary causes for<unk>  adenoma, and ionized calcium levels should be normal.
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