Primary hyperparathyroidism: diagnosis and management.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
A Khan

Abstract

To review the manifestations of primary hyperparathyroidism and the available treatment strategies. The epidemiologic and pathologic features of this endocrine disorder are outlined. Guidelines for surgical intervention are discussed, and the effectiveness of various medical treatments is summarized. Primary hyperparathyroidism, a common disorder, is diagnosed on the basis of hypercalcemia in the presence of increased parathyroid hormone levels as measured by immunoassay. Clinical manifestations are variable with many patients being asymptomatic at the time of diagnosis. Patients with severe disease require definitive surgical treatment. Surgical cure rates are high--approximately 95% in experienced hands. Indications for surgery include a serum calcium of more than 2.9 mmol/L (12 mg/dL), osteoporosis, recurrent renal stones, and parathyroid carcinoma. As well, it is recommend in individuals younger than 50 years of age. Patients with mild disease may have a benign natural history and may not have progression to severe disease. Asymptomatic individuals with mild hypercalcemia and close to normal bone mass and renal function may be managed medically, particularly those who are over the age of 50 years. Medical management include...Continue Reading

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Citations

Jun 15, 2006·Wiener klinische Wochenschrift·Payam S Pahlavan, Marianne C Severin
Oct 18, 2000·Endocrinology and Metabolism Clinics of North America·M S Eigelberger, O H Clark
May 1, 1997·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·S J Silverberg, J P Bilezikian
Jul 11, 2020·Journal of Holistic Nursing : Official Journal of the American Holistic Nurses' Association·Julia MillspaughCarole Reifsnyder
Jan 6, 2001·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Z Syed, A Khan

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