Skip to main content

Advertisement

SpringerLink
Log in

Italian Society of Endocrinology Consensus Statement: definition, evaluation and management of patients with mild primary hyperparathyroidism

  • Consensus Statement
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Notes

  1. Stone risk profile can be evaluated as indicated by Marangella et al. [46] using an electronic algorithm or may also be obtained by commercial laboratories.

References

  1. Marcocci C, Cetani F (2011) Clinical practice. Primary hyperparathyroidism. N Engl J Med 365(25):2389–2397. doi:10.1056/NEJMcp1106636

    Article  CAS  PubMed  Google Scholar 

  2. Bilezikian JP, Brandi ML, Eastell R, Silverberg SJ, Udelsman R, Marcocci C, Potts JT Jr (2014) Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop. J Clin Endocrinol Metab 99(10):3561–3569. doi:10.1210/jc.2014-1413

    Article  CAS  PubMed  Google Scholar 

  3. Swiglo BA, Murad MH, Schunemann HJ, Kunz R, Vigersky RA, Guyatt GH, Montori VM (2008) A case for clarity, consistency, and helpfulness: state-of-the-art clinical practice guidelines in endocrinology using the grading of recommendations, assessment, development, and evaluation system. J Clin Endocrinol Metab 93(3):666–673. doi:10.1210/jc.2007-1907

    Article  CAS  PubMed  Google Scholar 

  4. Dalemo S, Eggertsen R, Hjerpe P, Jansson S, Almqvist EG, Bengtsson Bostrom K (2013) Long-term follow-up of patients with elevated serum calcium concentrations in Swedish primary care. Scand J Prim Health Care 31(4):248–254. doi:10.3109/02813432.2013.861152

    Article  PubMed Central  PubMed  Google Scholar 

  5. Bollerslev J, Rolighed L, Mosekilde L (2011) Mild primary hyperparathyroidism and metabolism of vitamin D. IBMS BoneKEy 8:342–351

    Article  Google Scholar 

  6. Grieff M, Bushinsky DA (2011) Diuretics and disorders of calcium homeostasis. Semin Nephrol 31(6):535–541. doi:10.1016/j.semnephrol.2011.09.008

    Article  CAS  PubMed  Google Scholar 

  7. Lumachi F, Cappelletti P, Tozzoli R, Basso SM, Luisetto G, Camozzi V (2012) Diagnosis of alterations of serum calcium metabolism. Med Chem 8(4):551–555

    Article  CAS  PubMed  Google Scholar 

  8. Wermers RA, Kearns AE, Jenkins GD, Melton LJ 3rd (2007) Incidence and clinical spectrum of thiazide-associated hypercalcemia. Am J Med 120 (10):911 e919–915. doi:10.1016/j.amjmed.2006.07.044

  9. McHenry CR, Lee K (1996) Lithium therapy and disorders of the parathyroid glands. Endocr Pract 2(2):103–109. doi:10.4158/EP.2.2.103

    Article  CAS  PubMed  Google Scholar 

  10. Haden ST, Stoll AL, McCormick S, Scott J, Ge-H Fuleihan (1997) Alterations in parathyroid dynamics in lithium-treated subjects. J Clin Endocrinol Metab 82(9):2844–2848. doi:10.1210/jcem.82.9.4218

    CAS  PubMed  Google Scholar 

  11. Lally J, Lee B, McDonald C (2013) Prevalence of hypercalcaemia in patients on maintenance lithium therapy monitored in primary care. Ir Med J 106(1):15–17

    CAS  PubMed  Google Scholar 

  12. Christensen SE, Nissen PH, Vestergaard P, Heickendorff L, Brixen K, Mosekilde L (2008) Discriminative power of three indices of renal calcium excretion for the distinction between familial hypocalciuric hypercalcaemia and primary hyperparathyroidism: a follow-up study on methods. Clin Endocrinol (Oxf) 69(5):713–720. doi:10.1111/j.1365-2265.2008.03259.x

    Article  CAS  Google Scholar 

  13. Mackenzie-Feder J, Tsang J, Demyttenaere S (2012) Unsuspected pheochromocytoma: is it time for a registry? Can J Anaesth 59(1):112–113. doi:10.1007/s12630-011-9601-8

    Article  PubMed  Google Scholar 

  14. Ong GS, Walsh JP, Stuckey BG, Brown SJ, Rossi E, Ng JL, Nguyen HH, Kent GN, Lim EM (2012) The importance of measuring ionized calcium in characterizing calcium status and diagnosing primary hyperparathyroidism. J Clin Endocrinol Metab 97(9):3138–3145. doi:10.1210/jc.2012-1429

    Article  CAS  PubMed  Google Scholar 

  15. Tassone F, Gianotti L, Baffoni C, Visconti G, Pellegrino M, Cassibba S, Croce CG, Magro G, Cesario F, Attanasio R, Borretta G (2013) Vitamin D status in primary hyperparathyroidism: a Southern European perspective. Clin Endocrinol (Oxf) 79(6):784–790. doi:10.1111/cen.12210

    Article  CAS  Google Scholar 

  16. Carnevale V, Nieddu L, Romagnoli E, Battista C, Mascia ML, Chiodini I, Eller-Vainicher C, Frusciante V, Santini SA, La Porta M, Minisola S, Scillitani A (2010) Regulation of PTH secretion by 25-hydroxyvitamin D and ionized calcium depends on vitamin D status: a study in a large cohort of healthy subjects. Bone 47(3):626–630. doi:10.1016/j.bone.2010.06.013

    Article  CAS  PubMed  Google Scholar 

  17. Bollerslev J, Marcocci C, Sosa M, Nordenstrom J, Bouillon R, Mosekilde L (2011) Current evidence for recommendation of surgery, medical treatment and vitamin D repletion in mild primary hyperparathyroidism. Eur J Endocrinol 165(6):851–864. doi:10.1530/EJE-11-0589

    Article  CAS  PubMed  Google Scholar 

  18. Silverberg SJ, Brown I, Bilezikian JP (2002) Age as a criterion for surgery in primary hyperparathyroidism. Am J Med 113(8):681–684

    Article  PubMed  Google Scholar 

  19. Egan AM, Ryan J, Aziz MA, O’Dwyer TP, Byrne MM (2013) Primary hyperparathyroidism in a patient with familial hypocalciuric hypercalcaemia due to a novel mutation in the calcium-sensing receptor gene. J Bone Miner Metab 31(4):477–480. doi:10.1007/s00774-012-0399-4

    Article  PubMed  Google Scholar 

  20. Jayasena CN, Mahmud M, Palazzo F, Donaldson M, Meeran K, Dhillo WS (2011) Utility of the urine calcium-to-creatinine ratio to diagnose primary hyperparathyroidism in asymptomatic hypercalcaemic patients with vitamin D deficiency. Ann Clin Biochem 48(Pt 2):126–129. doi:10.1258/acb.2010.010202

    Article  CAS  PubMed  Google Scholar 

  21. Christensen SE, Nissen PH, Vestergaard P, Heickendorff L, Rejnmark L, Brixen K, Mosekilde L (2008) Plasma 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and parathyroid hormone in familial hypocalciuric hypercalcemia and primary hyperparathyroidism. Eur J Endocrinol 159(6):719–727. doi:10.1530/EJE-08-0440

    Article  CAS  PubMed  Google Scholar 

  22. Isaksen T, Nielsen CS, Christensen SE, Nissen PH, Heickendorff L, Mosekilde L (2011) Forearm bone mineral density in familial hypocalciuric hypercalcemia and primary hyperparathyroidism: a comparative study. Calcif Tissue Int 89(4):285–294. doi:10.1007/s00223-011-9517-x

    Article  CAS  PubMed  Google Scholar 

  23. Zini M, Attanasio R, Cesareo R, Emmolo I, Frasoldati A, Gianotti L, Guglielmi R, Piovesan A, Procopio M, Scillitani A, Versari A, Bollerslev J, Rao DS, Marcocci C, Borretta G, Italian Association of Clinical E (2012) AME position statement: primary hyperparathyroidism in clinical practice. J Endocrinol Invest 35(7 Suppl):2–21

    PubMed  Google Scholar 

  24. Shinall MC Jr, Dahir KM, Broome JT (2013) Differentiating familial hypocalciuric hypercalcemia from primary hyperparathyroidism. Endocr Pract 19(4):697–702. doi:10.4158/EP12284.RA

    Article  PubMed  Google Scholar 

  25. Pollak MR, Brown EM, Chou YH, Hebert SC, Marx SJ, Steinmann B, Levi T, Seidman CE, Seidman JG (1993) Mutations in the human Ca(2+)-sensing receptor gene cause familial hypocalciuric hypercalcemia and neonatal severe hyperparathyroidism. Cell 75(7):1297–1303

    Article  CAS  PubMed  Google Scholar 

  26. Nesbit MA, Hannan FM, Howles SA, Babinsky VN, Head RA, Cranston T, Rust N, Hobbs MR, Heath H 3rd, Thakker RV (2013) Mutations affecting G-protein subunit alpha11 in hypercalcemia and hypocalcemia. N Engl J Med 368(26):2476–2486. doi:10.1056/NEJMoa1300253

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  27. Nesbit MA, Hannan FM, Howles SA, Reed AA, Cranston T, Thakker CE, Gregory L, Rimmer AJ, Rust N, Graham U, Morrison PJ, Hunter SJ, Whyte MP, McVean G, Buck D, Thakker RV (2013) Mutations in AP2S1 cause familial hypocalciuric hypercalcemia type 3. Nat Genet 45(1):93–97. doi:10.1038/ng.2492

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Eller-Vainicher C, Chiodini I, Battista C, Viti R, Mascia ML, Massironi S, Peracchi M, D’Agruma L, Minisola S, Corbetta S, Cole DE, Spada A, Scillitani A (2009) Sporadic and MEN1-related primary hyperparathyroidism: differences in clinical expression and severity. J Bone Miner Res 24(8):1404–1410. doi:10.1359/jbmr.090304

    Article  PubMed  Google Scholar 

  29. Georgitsi M, Raitila A, Karhu A, van der Luijt RB, Aalfs CM, Sane T, Vierimaa O, Makinen MJ, Tuppurainen K, Paschke R, Gimm O, Koch CA, Gundogdu S, Lucassen A, Tischkowitz M, Izatt L, Aylwin S, Bano G, Hodgson S, De Menis E, Launonen V, Vahteristo P, Aaltonen LA (2007) Germline CDKN1B/p27Kip1 mutation in multiple endocrine neoplasia. J Clin Endocrinol Metab 92(8):3321–3325. doi:10.1210/jc.2006-2843

    Article  CAS  PubMed  Google Scholar 

  30. Malanga D, De Gisi S, Riccardi M, Scrima M, De Marco C, Robledo M, Viglietto G (2012) Functional characterization of a rare germline mutation in the gene encoding the cyclin-dependent kinase inhibitor p27Kip1 (CDKN1B) in a Spanish patient with multiple endocrine neoplasia-like phenotype. Eur J Endocrinol 166(3):551–560. doi:10.1530/EJE-11-0929

    Article  CAS  PubMed  Google Scholar 

  31. Pardi E, Mariotti S, Pellegata NS, Benfini K, Borsari S, Saponaro F, Torregrossa L, Cappai A, Satta C, Mastinu M, Marcocci C, Cetani F (2014) Functional characterization of a CDKN1B mutation in a Sardinian kindred with multiple endocrine neoplasia type 4 (MEN4). Endocr Connect 2015(4):1–8. doi:10.1530/EC-14-0116

    Article  Google Scholar 

  32. Alevizaki M (2013) Management of hyperparathyrodism (PHP) in MEN2 syndrome in Europe. Thyroid Res 6(Suppl1):S1–S10. doi:10.1186/1756-6614-6-S1-S10

    Google Scholar 

  33. Masi G, Barzon L, Iacobone M, Viel G, Porzionato A, Macchi V, De Caro R, Favia G, Palu G (2008) Clinical, genetic, and histopathologic investigation of CDC73-related familial hyperparathyroidism. Endocr Relat Cancer 15(4):1115–1126. doi:10.1677/ERC-08-0066

    Article  CAS  PubMed  Google Scholar 

  34. Frank-Raue K, Leidig-Bruckner G, Haag C, Schulze E, Lorenz A, Schmitz-Winnenthal H, Raue F (2011) Inactivating calcium-sensing receptor mutations in patients with primary hyperparathyroidism. Clin Endocrinol (Oxf) 75(1):50–55. doi:10.1111/j.1365-2265.2011.04059.x

    Article  CAS  Google Scholar 

  35. Newey PJ, Bowl MR, Cranston T, Thakker RV (2010) Cell division cycle protein 73 homolog (CDC73) mutations in the hyperparathyroidism–jaw tumor syndrome (HPT–JT) and parathyroid tumors. Hum Mutat 31(3):295–307. doi:10.1002/humu.21188

    Article  CAS  PubMed  Google Scholar 

  36. Cetani F, Pardi E, Ambrogini E, Lemmi M, Borsari S, Cianferotti L, Vignali E, Viacava P, Berti P, Mariotti S, Pinchera A, Marcocci C (2006) Genetic analyses in familial isolated hyperparathyroidism: implication for clinical assessment and surgical management. Clin Endocrinol (Oxf) 64(2):146–152. doi:10.1111/j.1365-2265.2006.02438.x

    Article  CAS  Google Scholar 

  37. Mizusawa N, Uchino S, Iwata T, Tsuyuguchi M, Suzuki Y, Mizukoshi T, Yamashita Y, Sakurai A, Suzuki S, Beniko M, Tahara H, Fujisawa M, Kamata N, Fujisawa K, Yashiro T, Nagao D, Golam HM, Sano T, Noguchi S, Yoshimoto K (2006) Genetic analyses in patients with familial isolated hyperparathyroidism and hyperparathyroidism-jaw tumour syndrome. Clin Endocrinol (Oxf) 65(1):9–16. doi:10.1111/j.1365-2265.2006.02534.x

    Article  CAS  Google Scholar 

  38. Starker LF, Akerstrom T, Long WD, Delgado-Verdugo A, Donovan P, Udelsman R, Lifton RP, Carling T (2012) Frequent germ-line mutations of the MEN1, CASR, and HRPT2/CDC73 genes in young patients with clinically non-familial primary hyperparathyroidism. Horm Cancer 3(1–2):44–51. doi:10.1007/s12672-011-0100-8

    Article  CAS  PubMed  Google Scholar 

  39. Vignali E, Viccica G, Diacinti D, Cetani F, Cianferotti L, Ambrogini E, Banti C, Del Fiacco R, Bilezikian JP, Pinchera A, Marcocci C (2009) Morphometric vertebral fractures in postmenopausal women with primary hyperparathyroidism. J Clin Endocrinol Metab 94(7):2306–2312. doi:10.1210/jc.2008-2006

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  40. Eastell R, Arnold A, Brandi ML, Brown EM, D’Amour P, Hanley DA, Rao DS, Rubin MR, Goltzman D, Silverberg SJ, Marx SJ, Peacock M, Mosekilde L, Bouillon R, Lewiecki EM (2009) Diagnosis of asymptomatic primary hyperparathyroidism: proceedings of the third international workshop. J Clin Endocrinol Metab 94(2):340–350. doi:10.1210/jc.2008-1758

    Article  CAS  PubMed  Google Scholar 

  41. Rolighed L, Rejnmark L, Sikjaer T, Heickendorff L, Vestergaard P, Mosekilde L, Christiansen P (2014) Vitamin D treatment in primary hyperparathyroidism: a randomized placebo controlled trial. J Clin Endocrinol Metab 99(3):1072–1080. doi:10.1210/jc.2013-3978

    CAS  PubMed  Google Scholar 

  42. Shah VN, Shah CS, Bhadada SK, Rao DS (2014) Effect of 25 (OH) D replacements in patients with primary hyperparathyroidism (PHPT) and coexistent vitamin D deficiency on serum 25(OH) D, calcium and PTH levels: a meta-analysis and review of literature. Clin Endocrinol (Oxf) 80(6):797–803. doi:10.1111/cen.12398

    Article  CAS  Google Scholar 

  43. Corbetta S, Baccarelli A, Aroldi A, Vicentini L, Fogazzi GB, Eller-Vainicher C, Ponticelli C, Beck-Peccoz P, Spada A (2005) Risk factors associated to kidney stones in primary hyperparathyroidism. J Endocrinol Invest 28(2):122–128

    Article  CAS  PubMed  Google Scholar 

  44. Gutteridge DH, Gruber HE, Kermode DG, Worth GK (1999) Thirty cases of concurrent Paget’s disease and primary hyperparathyroidism: sex distribution, histomorphometry, and prediction of the skeletal response to parathyroidectomy. Calcif Tissue Int 65(6):427–435

    Article  CAS  PubMed  Google Scholar 

  45. Tassone F, Gianotti L, Emmolo I, Ghio M, Borretta G (2009) Glomerular filtration rate and parathyroid hormone secretion in primary hyperparathyroidism. J Clin Endocrinol Metab 94(11):4458–4461. doi:10.1210/jc.2009-0587

    Article  CAS  PubMed  Google Scholar 

  46. Marangella M, Petrarulo M, Daniele PG, Sammartano S (2002) LithoRisk: a software for calculating and visualising nephrolithiasis risk profiles. G Ital Nefrol 19(6):693–698

    CAS  PubMed  Google Scholar 

  47. Silverberg SJ, Clarke BL, Peacock M, Bandeira F, Boutroy S, Cusano NE, Dempster D, Lewiecki EM, Jian-Min L, Minisola S, Rejnmark L, Silva BC, Walker MD, Bilezikian JP (2014) Current issues in the presentation of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop. J Clin Endocrinol Metab 99(10):3580–3594. doi:10.1210/jc.2014-1415

    Article  CAS  PubMed  Google Scholar 

  48. Lewiecki EM, Laster AJ (2006) Clinical review: clinical applications of vertebral fracture assessment by dual-energy x-ray absorptiometry. J Clin Endocrinol Metab 91(11):4215–4222. doi:10.1210/jc.2006-1178

    Article  CAS  PubMed  Google Scholar 

  49. Gianotti L, Tassone F, Cesario F, Pia A, Razzore P, Magro G, Piovesan A, Borretta G (2006) A slight decrease in renal function further impairs bone mineral density in primary hyperparathyroidism. J Clin Endocrinol Metab 91(8):3011–3016. doi:10.1210/jc.2006-0070

    Article  CAS  PubMed  Google Scholar 

  50. Walker MD, Dempster DW, McMahon DJ, Udesky J, Shane E, Bilezikian JP, Silverberg SJ (2012) Effect of renal function on skeletal health in primary hyperparathyroidism. J Clin Endocrinol Metab 97(5):1501–1507. doi:10.1210/jc.2011-3072

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  51. Eller-Vainicher C, Battista C, Guarnieri V, Muscarella S, Palmieri S, Salcuni AS, Guglielmi G, Corbetta S, Minisola S, Spada A, Hendy GN, Cole DE, Chiodini I, Scillitani A (2014) Factors associated with vertebral fracture risk in patients with primary hyperparathyroidism. Eur J Endocrinol 171(3):399–406. doi:10.1530/EJE-14-0343

    Article  CAS  PubMed  Google Scholar 

  52. Romagnoli E, Cipriani C, Nofroni I, Castro C, Angelozzi M, Scarpiello A, Pepe J, Diacinti D, Piemonte S, Carnevale V, Minisola S (2013) “Trabecular Bone Score” (TBS): an indirect measure of bone micro-architecture in postmenopausal patients with primary hyperparathyroidism. Bone 53(1):154–159. doi:10.1016/j.bone.2012.11.041

    Article  PubMed  Google Scholar 

  53. Walker MD, Rubin M, Silverberg SJ (2013) Nontraditional manifestations of primary hyperparathyroidism. J Clin Densitom 16(1):40–47. doi:10.1016/j.jocd.2012.11.008

    Article  PubMed Central  PubMed  Google Scholar 

  54. Yu N, Donnan PT, Flynn RW, Murphy MJ, Smith D, Rudman A, Leese GP (2010) Increased mortality and morbidity in mild primary hyperparathyroid patients. The Parathyroid Epidemiology and Audit Research Study (PEARS). Clin Endocrinol (Oxf) 73(1):30–34. doi:10.1111/j.1365-2265.2009.03766.x

    Google Scholar 

  55. Bollerslev J, Rosen T, Mollerup CL, Nordenstrom J, Baranowski M, Franco C, Pernow Y, Isaksen GA, Godang K, Ueland T, Jansson S, Group SS (2009) Effect of surgery on cardiovascular risk factors in mild primary hyperparathyroidism. J Clin Endocrinol Metab 94(7):2255–2261. doi:10.1210/jc.2008-2742

    Article  CAS  PubMed  Google Scholar 

  56. Bollerslev J, Jansson S, Mollerup CL, Nordenstrom J, Lundgren E, Torring O, Varhaug JE, Baranowski M, Aanderud S, Franco C, Freyschuss B, Isaksen GA, Ueland T, Rosen T (2007) Medical observation, compared with parathyroidectomy, for asymptomatic primary hyperparathyroidism: a prospective, randomized trial. J Clin Endocrinol Metab 92(5):1687–1692. doi:10.1210/jc.2006-1836

    Article  CAS  PubMed  Google Scholar 

  57. Rao DS, Phillips ER, Divine GW, Talpos GB (2004) Randomized controlled clinical trial of surgery versus no surgery in patients with mild asymptomatic primary hyperparathyroidism. J Clin Endocrinol Metab 89(11):5415–5422. doi:10.1210/jc.2004-0028

    Article  CAS  PubMed  Google Scholar 

  58. Ambrogini E, Cetani F, Cianferotti L, Vignali E, Banti C, Viccica G, Oppo A, Miccoli P, Berti P, Bilezikian JP, Pinchera A, Marcocci C (2007) Surgery or surveillance for mild asymptomatic primary hyperparathyroidism: a prospective, randomized clinical trial. J Clin Endocrinol Metab 92(8):3114–3121. doi:10.1210/jc.2007-0219

    Article  CAS  PubMed  Google Scholar 

  59. Blanchard C, Mathonnet M, Sebag F, Caillard C, Hamy A, Volteau C, Heymann MF, Wyart V, Drui D, Roy M, Cariou B, Archambeaud F, Rodien P, Henry JF, Zarnegar R, Hardouin JB, Mirallie E (2013) Surgery for ‘asymptomatic’ mild primary hyperparathyroidism improves some clinical symptoms postoperatively. Eur J Endocrinol 169(5):665–672. doi:10.1530/EJE-13-0502

    Article  CAS  PubMed  Google Scholar 

  60. Rubin MR, Bilezikian JP, McMahon DJ, Jacobs T, Shane E, Siris E, Udesky J, Silverberg SJ (2008) The natural history of primary hyperparathyroidism with or without parathyroid surgery after 15 years. J Clin Endocrinol Metab 93(9):3462–3470. doi:10.1210/jc.2007-1215

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  61. Lundstam K, Heck A, Mollerup C, Godang K, Baranowski M, Pernow Y, Erik Varhaug J, Hessman O, Rosen T, Nordenstrom J, Jansson S, Hellstrom M, Bollerslev J (2015) Effects of parathyroidectomy versus observation on the development of vertebral fractures in mild primary hyperparathyroidism. J Clin Endocrinol Metab. doi:10.1210/jc.2014-3441

    PubMed  Google Scholar 

  62. Cassibba S, Pellegrino M, Gianotti L, Baffoni C, Baralis E, Attanasio R, Guarnieri A, Borretta G, Tassone F (2014) Silent renal stones in primary hyperparathyroidism: prevalence and clinical features. Endocr Pract 20(11):1137–1142. doi:10.4158/EP14074.OR

    Article  PubMed  Google Scholar 

  63. Rejnmark L, Vestergaard P, Mosekilde L (2011) Nephrolithiasis and renal calcifications in primary hyperparathyroidism. J Clin Endocrinol Metab 96(8):2377–2385. doi:10.1210/jc.2011-0569

    Article  CAS  PubMed  Google Scholar 

  64. NIH conference (1991) Gastrointestinal surgery for severe obesity. Consensus development conference panel. Ann Intern Med 115(12):956–961

    Article  Google Scholar 

  65. Bilezikian JP, Potts JT Jr, Fuleihan Gel H, Kleerekoper M, Neer R, Peacock M, Rastad J, Silverberg SJ, Udelsman R, Wells SA (2002) Summary statement from a workshop on asymptomatic primary hyperparathyroidism: a perspective for the 21st century. J Clin Endocrinol Metab 87(12):5353–5361. doi:10.1210/jc.2002-021370

    Article  CAS  PubMed  Google Scholar 

  66. Walker MD, McMahon DJ, Inabnet WB, Lazar RM, Brown I, Vardy S, Cosman F, Silverberg SJ (2009) Neuropsychological features in primary hyperparathyroidism: a prospective study. J Clin Endocrinol Metab 94(6):1951–1958. doi:10.1210/jc.2008-2574

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  67. Silverberg SJ, Shane E, Jacobs TP, Siris E, Bilezikian JP (1999) A 10-year prospective study of primary hyperparathyroidism with or without parathyroid surgery. N Engl J Med 341(17):1249–1255. doi:10.1056/NEJM199910213411701

    Article  CAS  PubMed  Google Scholar 

  68. Schneider DF, Burke JF, Ojomo KA, Clark N, Mazeh H, Sippel RS, Chen H (2013) Multigland disease and slower decline in intraoperative PTH characterize mild primary hyperparathyroidism. Ann Surg Oncol 20(13):4205–4211. doi:10.1245/s10434-013-3190-4

    Article  PubMed Central  PubMed  Google Scholar 

  69. Udelsman R, Akerstrom G, Biagini C, Duh QY, Miccoli P, Niederle B, Tonelli F (2014) The surgical management of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop. J Clin Endocrinol Metab 99(10):3595–3606. doi:10.1210/jc.2014-2000

    Article  CAS  PubMed  Google Scholar 

  70. Civelek AC, Ozalp E, Donovan P, Udelsman R (2002) Prospective evaluation of delayed technetium-99 m sestamibi SPECT scintigraphy for preoperative localization of primary hyperparathyroidism. Surgery 131(2):149–157

    Article  PubMed  Google Scholar 

  71. Van Husen R, Kim LT (2004) Accuracy of surgeon-performed ultrasound in parathyroid localization. World J Surg 28(11):1122–1126. doi:10.1007/s00268-004-7485-2

    Article  PubMed  Google Scholar 

  72. Goswami S, Ghosh S (2012) Hyperparathyroidism: cancer and mortality. Indian J Endocrinol Metab 16(Suppl 2):S217–S220. doi:10.4103/2230-8210.104042

    PubMed Central  PubMed  Google Scholar 

  73. Espiritu RP, Kearns AE, Vickers KS, Grant C, Ryu E, Wermers RA (2011) Depression in primary hyperparathyroidism: prevalence and benefit of surgery. J Clin Endocrinol Metab 96(11):E1737–E1745. doi:10.1210/jc.2011-1486

    Article  CAS  PubMed  Google Scholar 

  74. Kahal H, Aye M, Rigby AS, Sathyapalan T, England RJ, Atkin SL (2012) The effect of parathyroidectomy on neuropsychological symptoms and biochemical parameters in patients with asymptomatic primary hyperparathyroidism. Clin Endocrinol (Oxf) 76(2):196–200. doi:10.1111/j.1365-2265.2011.04197.x

    Article  CAS  Google Scholar 

  75. Insogna KL, Mitnick ME, Stewart AF, Burtis WJ, Mallette LE, Broadus AE (1985) Sensitivity of the parathyroid hormone-1,25-dihydroxyvitamin D axis to variations in calcium intake in patients with primary hyperparathyroidism. N Engl J Med 313(18):1126–1130. doi:10.1056/NEJM198510313131805

    Article  CAS  PubMed  Google Scholar 

  76. Jorde R, Szumlas K, Haug E, Sundsfjord J (2002) The effects of calcium supplementation to patients with primary hyperparathyroidism and a low calcium intake. Eur J Nutr 41(6):258–263. doi:10.1007/s00394-002-0383-1

    Article  CAS  PubMed  Google Scholar 

  77. Locker FG, Silverberg SJ, Bilezikian JP (1997) Optimal dietary calcium intake in primary hyperparathyroidism. Am J Med 102(6):543–550

    Article  CAS  PubMed  Google Scholar 

  78. Marcocci C, Bollerslev J, Khan AA, Shoback DM (2014) Medical management of primary hyperparathyroidism: proceedings of the Fourth International Workshop on the Management of Asymptomatic Primary Hyperparathyroidism. J Clin Endocrinol Metab 99(10):3607–3618. doi:10.1210/jc.2014-1417

    Article  CAS  PubMed  Google Scholar 

  79. Minisola S, Romagnoli E, Scillitani A, Rao SD (2014) Hypovitaminosis D in primary hyperparathyroidism: to treat or not to treat? That is the question. J Endocrinol Invest 37(5):413–414. doi:10.1007/s40618-014-0060-2

    Article  PubMed  Google Scholar 

  80. Romagnoli E, Pepe J, Piemonte S, Cipriani C, Minisola S (2013) Management of endocrine disease: value and limitations of assessing vitamin D nutritional status and advised levels of vitamin D supplementation. Eur J Endocrinol 169(4):R59–R69. doi:10.1530/EJE-13-0435

    Article  CAS  PubMed  Google Scholar 

  81. Romagnoli E, Carnevale V, Biondi P, Minisola S (2014) Vitamin D supplementation: when and how? J Endocrinol Invest 37(7):603–607. doi:10.1007/s40618-014-0071-z

    Article  PubMed  Google Scholar 

  82. Khan AA (2013) Medical management of primary hyperparathyroidism. J Clin Densitom 16(1):60–63. doi:10.1016/j.jocd.2012.11.010

    Article  PubMed  Google Scholar 

  83. Sankaran S, Gamble G, Bolland M, Reid IR, Grey A (2010) Skeletal effects of interventions in mild primary hyperparathyroidism: a meta-analysis. J Clin Endocrinol Metab 95(4):1653–1662. doi:10.1210/jc.2009-2384

    Article  CAS  PubMed  Google Scholar 

  84. EMA (2008) http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/medicines/000570/human_med_000903.jsp&mid=WC0p01ac058001d124. Accessed 18 Nov 2013

  85. FDA (2011) www.accessdata.fda.gov/drugsatfda_docs/label/2011/021688s017lbl.pdf. Accessed 18 Nov 2013

  86. Saponaro F, Faggiano A, Grimaldi F, Borretta G, Brandi ML, Minisola S, Frasoldati A, Papini E, Scillitani A, Banti C, Del Prete M, Vescini F, Gianotti L, Cavalli L, Romagnoli E, Colao A, Cetani F, Marcocci C (2013) Cinacalcet in the management of primary hyperparathyroidism: post marketing experience of an Italian multicentre group. Clin Endocrinol (Oxf) 79(1):20–26. doi:10.1111/cen.12108

    Article  CAS  Google Scholar 

  87. Cetani F, Saponaro F, Banti C, Cianferotti L, Vignali E, Chiavistelli S, Viccica G, Pinchera A, Marcocci C (2012) Cinacalcet efficacy in patients with moderately severe primary hyperparathyroidism according to the European Medicine Agency prescription labeling. J Endocrinol Invest 35(7):655–660. doi:10.3275/7970

    CAS  PubMed  Google Scholar 

  88. Diaz-Soto G, Linglart A, Senat MV, Kamenicky P, Chanson P (2013) Primary hyperparathyroidism in pregnancy. Endocrine 44(3):591–597. doi:10.1007/s12020-013-9980-4

    Article  CAS  PubMed  Google Scholar 

  89. Som M, Stroup JS (2011) Primary hyperparathyroidism and pregnancy. Proc (Bayl Univ Med Cent) 24(3):220–223

    Google Scholar 

  90. Horjus C, Groot I, Telting D, van Setten P, van Sorge A, Kovacs CS, Hermus A, de Boer H (2009) Cinacalcet for hyperparathyroidism in pregnancy and puerperium. J Pediatr Endocrinol Metab 22(8):741–749

    Article  CAS  PubMed  Google Scholar 

  91. Thakker RV, Newey PJ, Walls GV, Bilezikian J, Dralle H, Ebeling PR, Melmed S, Sakurai A, Tonelli F, Brandi ML, Endocrine S (2012) Clinical practice guidelines for multiple endocrine neoplasia type 1 (MEN1). J Clin Endocrinol Metab 97(9):2990–3011. doi:10.1210/jc.2012-1230

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Author information

Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 27, 56127, Pisa, Italy

    C. Marcocci

  2. Department of Surgery and Translational Medicine, University of Florence, Largo Brambilla 3, 50134, Firenze, Italy

    M. L. Brandi

  3. Unit of Endocrinology, Ospedale “Casa Sollievo della Sofferenza”, IRCCS, 71013, San Giovanni Rotondo, FG, Italy

    A. Scillitani

  4. Department of Clinical Medicine and Surgery, University “Federico II” of Naples, Via Pansini 5, 80131, Napoli, Italy

    A. Faggiano

  5. Section of Endocrinology, Diabetology and Metabolism, Azienda Ospedaliera S.Croce e Carle, Via M Coppino 26, 12100, Cuneo, Italy

    L. Gianotti

  6. Department of Motor Sciences and Health, “Foro Italico” Rome University, Piazza L. de Bosis 6, 00135, Roma, Italy

    S. Migliaccio

  7. Department of Internal Medicine and Medical DIsciplines, “Sapienza” Rome University, Viale del Policlinico 155, 00161, Roma, Italy

    S. Minisola

  8. Department of Biomedical Sciences for Health, University of Milan, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, MI, Italy

    S. Corbetta

Authors
  1. C. Marcocci
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. L. Brandi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Scillitani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Corbetta
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Faggiano
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. L. Gianotti
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S. Migliaccio
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. S. Minisola
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Marcocci.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Marcocci, C., Brandi, M.L., Scillitani, A. et al. Italian Society of Endocrinology Consensus Statement: definition, evaluation and management of patients with mild primary hyperparathyroidism. J Endocrinol Invest 38, 577–593 (2015). https://doi.org/10.1007/s40618-015-0261-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40618-015-0261-3

Keywords

Search

Navigation