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Primary hyperparathyroidism: Diagnosis, differential diagnosis, and evaluation

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


The diagnosis of hyperparathyroidism is usually first suspected because of the finding of an elevated serum calcium concentration. If hypercalcemia is confirmed on a repeat sample, all of its causes should be considered (table 1). (See "Etiology of hypercalcemia".)

The serum parathyroid hormone (PTH) concentration should then be measured using a two-site immunoradiometric sandwich assay. The diagnosis of primary hyperparathyroidism (PHPT) is usually made by finding a PTH concentration that is frankly elevated or within the normal range but inappropriately normal given the patient's hypercalcemia (figure 1).

The diagnosis, differential diagnosis, and evaluation of PHPT will be discussed here. Other aspects of PHPT are reviewed elsewhere.

(See "Primary hyperparathyroidism: Clinical manifestations".)

(See "Primary hyperparathyroidism: Management".)

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Literature review current through: Nov 2017. | This topic last updated: Nov 20, 2017.
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