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Primary hyperparathyroidism: Management

Authors
Shonni J Silverberg, MD
Ghada El-Hajj Fuleihan, MD, MPH
Section Editor
Clifford J Rosen, MD
Deputy Editor
Jean E Mulder, MD

INTRODUCTION

Primary hyperparathyroidism (PHPT) is often recognized as a result of biochemical screening or as part of an evaluation for decreased bone mass. Most of the patients have serum calcium concentrations within 1 to 1.5 mg/dL (0.25 to 0.375 mmol/L) above the upper limit of normal. Among such patients, the majority are women over age 50 years who are asymptomatic.

This topic reviews the management of PHPT in general and the risks and benefits of medical versus surgical management in asymptomatic patients. The clinical manifestations and diagnosis of PHPT, diagnostic localization of abnormal parathyroid glands, and the methods of surgical removal are discussed in greater detail elsewhere.

The decision regarding medical versus surgical treatment does not apply to patients who have familial hypocalciuric hypercalcemia. Patients with this disorder have mild hypercalcemia, few if any symptoms, no evidence of end organ damage from their disease, and no benefit from parathyroidectomy.

(See "Primary hyperparathyroidism: Clinical manifestations".)

(See "Primary hyperparathyroidism: Diagnosis, differential diagnosis, and evaluation".)

                       

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Literature review current through: Nov 2016. | This topic last updated: Thu May 07 00:00:00 GMT+00:00 2015.
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