Hypercalcemia with a parathyroid hormone level of ≤50 pg/mL: Is this primary hyperparathyroidism?

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Abstract

<p xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="first" dir="auto" id="d8855180e93">Primary hyperparathyroidism is characterized by hypercalcemia with inappropriately normal or elevated parathyroid hormone. However, the absolute parathyroid hormone value that is defined as inappropriately normal is unclear. We reviewed our experience with parathyroidectomy in patients with hypercalcemia and parathyroid hormone of ≤50.0 pg/mL (normal range 12.0-88.0 pg/mL). </p>

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Primary Hyperparathyroidism

Leonardo Bandeira, John Bilezikian (2016)

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.

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Diagnosis and Management of Primary Hyperparathyroidism

Catherine Zhu, Cord Sturgeon, Michael W Yeh (2020)

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Surgery for primary hyperparathyroidism: are the consensus guidelines being followed?

Michael W Yeh, James E. Wiseman, Philip Ituarte … (2012)

To determine parathyroidectomy (PTx) rates in patients who satisfy the consensus guidelines for surgical treatment of primary hyperparathyroidism (PHPT).