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Review
. 2024 Oct;25(5):875-896.
doi: 10.1007/s11154-024-09899-5. Epub 2024 Aug 20.

Primary hyperparathyroidism: from guidelines to outpatient clinic

Andrea Palermo  1   2 , Gaia Tabacco  3   4 , Polyzois Makras  5 , Guido Zavatta  6   7 , Pierpaolo Trimboli  8   9 , Elena Castellano  10 , Maria P Yavropoulou  11 , Anda Mihaela Naciu  3   4 , Athanasios D Anastasilakis  11
Affiliations
Review

Primary hyperparathyroidism: from guidelines to outpatient clinic

Andrea Palermo et al. Rev Endocr Metab Disord. 2024 Oct.

Abstract

Primary hyperparathyroidism (PHPT) is a common endocrine disease characterized by hypercalcemia due to inappropriately high parathyroid hormone secretion. While in the typical, symptomatic form of the disease diagnosis is set easily and standard management is surgical removal of the hyperfunctioning parathyroid (HP), this may not be the case in more subtle forms of PHPT, such as the asymptomatic and the normocalcemic PHPT. Localization of the HP could also be challenging, especially in small-sized adenomas, ectopic lesions or multiglandular disease. An experienced surgical team is essential to achieve curative parathyroidectomy. In this article, we used illustrative clinical vignettes to dissect the approach to the patient with PHPT, from the diagnosis establishment to the suggested investigation to identify classical and non-classical PHPT features and the methodology to locate the abnormal tissue. Accordingly, we elaborated on appropriate management, both surgical and conservative.

Keywords: Calcium; PTH; Parathyroid gland; Primary hyperparathyroidism.

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References

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