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Review
. 2016 Jan 4:5:F1000 Faculty Rev-1.
doi: 10.12688/f1000research.7039.1. eCollection 2016.

Primary Hyperparathyroidism

Leonardo Bandeira  1 , John Bilezikian  1
Affiliations
Review

Primary Hyperparathyroidism

Leonardo Bandeira et al. F1000Res. .

Abstract

Over the past several generations, primary hyperparathyroidism (PHTP) has undergone a change in its clinical presentation in many countries from a symptomatic disease to an asymptomatic one. The reasons for this change in clinical presentation are related to the widespread use of biochemical screening tests, to the measurement of PTH more routinely in the evaluation of metabolic bone disease and to the status of vitamin D sufficiency in the population. Along with recognition of a broader clinical spectrum of disease, including a more recently recognized normocalcemic variant, has come an appreciation that the evaluation of classic target organs that can be affected in PHPT, such as the skeleton and the kidneys, require more advanced imaging technology for complete evaluation. It is clear that even in asymptomatic patients, evidence for microstructural disease in the skeleton and calcifications in the kidneys can be demonstrated often. Potential non-classical manifestations of PHPT related to neurocognition and the cardiovascular system continue to be of interest. As a result of these advances, revised guidelines for the management of asymptomatic PHPT have been recently published to help the clinician determine whether surgery is appropriate or whether a more conservative approach is acceptable.

Keywords: Primary Hyperparathyroidism; adenomas; parathyroid glands.

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Conflict of interest statement

Competing interests: The authors declare that they have no competing interests.

No competing interests were disclosed.

Figures

Figure 1.
Figure 1.. Approach in normocalcemic primary hyperparathyroidism (NPHPT) .
BMD, bone mineral density; DXA, dual-energy X-ray absorptiometry; PHPT, primary hyperparathyroidism; PTH, parathyroid hormone.
See this image and copyright information in PMC

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