Normocalcaemic primary hyperparathyroidism: An update on diagnostic and management challenges.

Abstract:

:Normocalcaemic primary hyperparathyroidism is a condition that can present with intermittent hypercalcemia or may evolve into hypercalcemic primary hyperparathyroidism. This milder biochemical entity remains incompletely understood because of a lack of long-term health outcomes regarding both medical and surgical approaches to its management. Medical therapies have shown some efficacy. A limited number of studies have found that bisphosphonates increase bone mineral density, and calcimimetics may decrease the risk of nephrolithiasis in patients with normocalcaemic primary hyperparathyroidism. Studies have also described patient outcomes after applying the same surgical criteria used for patients with hypercalcaemic primary hyperparathyroidism to those with the normocalcaemic form of the disease. These studies suggest that parathyroid surgery appears to be effective in normalizing elevated serum parathyroid hormone concentrations and decreasing adverse renal and skeletal outcomes in patients with normocalcaemic hyperparathyroidism. Given the available data and overall lack of consensus regarding the optimal management of these patients, a reasonable approach is to tailor treatment to the individual patient by considering their risk factors for new or accelerated bone loss, kidney stones, diminished quality of life, and cardiovascular disease.

journal_name

Clin Endocrinol (Oxf)

journal_title

Clinical endocrinology

authors

Dawood NB,Yan KL,Shieh A,Livhits MJ,Yeh MW,Leung AM

doi

10.1111/cen.14315

subject

Has Abstract

pub_date

2020-11-01 00:00:00

pages

519-527

issue

5

eissn

0300-0664

issn

1365-2265

journal_volume

93

pub_type

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