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      Investigating patients with normocalcemic hyperparathyroidism: When is a parathyroid scintigraphy indicated?

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          Abstract

          In clinical practice, physicians often encounter patients with persistent elevated serum parathyroid hormone levels and normal serum calcium levels, a state known as normocalcemic hyperparathyroidism (NHPT). The investigation of NHPT cases can lead to unnecessary use of parathyroid scintigraphy (PS) and consequently unnecessary health-care costs. In this clinical review, the most common causes of NHPT and the possible indications for PS performance in such cases are mainly presented and discussed.

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          Most cited references 25

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          Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the third international workshop.

           A. K. Azad Khan,  J. Potts,   (2009)
          Asymptomatic primary hyperparathyroidism (PHPT) is a common clinical problem. The purpose of this report is to guide the use of diagnostics and management for this condition in clinical practice. Interested professional societies selected representatives for the consensus committee and provided funding for a one-day meeting. A subgroup of this committee set the program and developed key questions for review. Consensus was established at a closed meeting that followed and at subsequent discussions. Each question was addressed by a relevant literature search (on PubMed), and the data were presented for discussion at the group meeting. Consensus was achieved by a group meeting. Statements were prepared and reviewed by all authors who represented the Planning Committee and the participating professional societies.
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            Normocalcemic primary hyperparathyroidism.

            Primary hyperparathyroidism, a common endocrine disorder, is traditionally defined by hypercalcemia and elevated levels of parathyroid hormone (PTH). A newer presentation of primary hyperparathyroidism has been described over the past decade, in which PTH is elevated but serum calcium is consistently normal, in the absence of secondary causes of hyperparathyroidism, such as renal disease or vitamin D deficiency. Recognition of this phenotype of primary hyperparathyroidism, normocalcemic primary hyperparathyroidism, supports a biphasic chronological time course in some individuals in which PTH levels are first elevated but serum calcium is normal, followed by the development of frank hypercalcemia. This review focuses on the available literature regarding this newly described phenotype of primary hyperparathyroidism. Copyright © 2013 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.
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              SNM practice guideline for parathyroid scintigraphy 4.0.

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                Author and article information

                Journal
                World J Nucl Med
                World J Nucl Med
                WJNM
                World Journal of Nuclear Medicine
                Wolters Kluwer - Medknow (India )
                1450-1147
                1607-3312
                Jul-Sep 2019
                : 18
                : 3
                : 227-231
                Affiliations
                Department of Internal Medicine, Naval Hospital of Crete, Chania, Greece
                Author notes
                Address for correspondence: Dr. Elias E. Mazokopakis, K. Mitsotaki 36, Chania 73 100, Crete, Greece. E-mail: emazokopakis@ 123456yahoo.gr
                Article
                WJNM-18-227
                10.4103/wjnm.WJNM_61_18
                6714157
                Copyright: © 2019 World Journal of Nuclear Medicine

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

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