Primary hyperparathyroidism - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Primary hyperparathyroidism is confirmed biochemically with synchronous elevation of serum calcium and inappropriate elevation of parathyroid hormone (PTH).
Normal serum intact PTH in the setting of hypercalcemia does not rule out disease.
Depression, cognitive changes, change in sleep pattern, fatigue, and myalgia or muscle weakness are nonspecific subjective complaints. There may be a history of nephrolithiasis or low bone mineral density.
Physical examination is usually normal, but examination of the neck is essential to look for a hard, dense mass, suggestive of parathyroid carcinoma.
Parathyroidectomy is the only definitive cure. Monitoring is an option for patients who have mild hypercalcemia without surgical indications, such as renal stones, impaired kidney function, or osteoporosis.

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Definition

Epidemiology

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Citations

Key Articles

Bilezikian JP, Khan AA, Silverberg SJ, et al. Evaluation and management of primary hyperparathyroidism: summary statement and guidelines from the fifth international workshop. J Bone Miner Res. 2022 Nov;37(11):2293-314.[Abstract][Full Text]
Wilhelm SM, Wang TS, Ruan DT, et al. The American Association of Endocrine Surgeons guidelines for definitive management of primary hyperparathyroidism. JAMA Surg. 2016 Oct 1;151(10):959-68.[Abstract][Full Text]
Bollerslev J, Rejnmark L, Zahn A, et al. European expert consensus on practical management of specific aspects of parathyroid disorders in adults and in pregnancy: recommendations of the ESE educational program of parathyroid disorders. Eur J Endocrinol. 2022 Feb 1;186(2):R33-63.[Abstract][Full Text]
Walker MD, Silverberg SJ. Primary hyperparathyroidism. Nat Rev Endocrinol. 2018 Feb;14(2):115-25.[Abstract][Full Text]
Petranović Ovčariček P, Giovanella L, Carrió Gasset I, et al. The EANM practice guidelines for parathyroid imaging. Eur J Nucl Med Mol Imaging. 2021 Aug;48(9):2801-2822.[Abstract][Full Text]

Referenced Articles

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